We’ve all been taught to monitor our cholesterol as a cardiac warning sign. In fact, this is a pretty weak predictor of heart attack risk. But did you know that knee or hip arthritis may well be a cardiac warning sign all by itself? At least that’s what a new study on the association between arthritis and heart attack suggests. This hits close to home for our practice, as most of our patients have some form of arthritis. For many, we can effectively treat the arthritis in their joints, but what’s going on that’s also affecting their heart – and what can be done about it?
Most people think of inflammation as what happens when you do something like sprain your ankle: it swells up dramatically. The swelling that results from an injury is acute inflammation, which is a crucial part of the repair process. When you injure yourself an army of cells is called in for the repair job and once that’s complete, the workman leave, turning off the light switch behind them.
There is however, another type of inflammation, Chronic inflammation. This occurs when that inflammation light switch gets stuck, and the workman tire, but can never leave because of an ongoing repair job that they can never complete. This can occur for many reasons. One of those is an unstable joint with constant wear and tear. As the unnatural forces from instability breakdown cartilage continually, the inability to complete the task and turn out the light produces inferior cartilage which is then more easily broken down, and the cycle continues. It also happens in joints when there is a metabolic syndrome (obesity, high blood pressure, and poor blood sugar control). In this scenario, the working conditions for our repair guys are made so horrible by pre-diabetes that they can also never finish the construction job and chronic inflammation ensues. That same process of incomplete repair and chronic inflammation can happen in many body systems, not just in joints.
In the same way leaving the inflammation switch on in a joint ultimately results in cartilage breakdown, inflammation in the cardiovascular system creates a similar cycle. The constant inflammation can lead to damage in arteries. This damage can cause plaques of the type that can rupture and this can eventually lead to a blocked artery in the heart and an interruption of blood flow also known as a heart attack.
The meta-analysis study searched for arthritis studies performed between 1980 and 2015. After correcting for things like age and sex, they sought to identify and compare incidents of Myocardial Infarction (heart attack) across 5 different types of arthritis
Out of the 52 studies that qualified, an increased risk of MI was found across the board with Rheumatoid arthritis with the highest increased risk, next was arthritis caused by Gout, then Psoriatic Arthritis, follwed by Osteoarthritis and Ankalyzing Spondolytis with the least increased risk. Their conclusion was that since an Arthritis and Heart Attack link had been established, intervention targeted at better Cardiovascular risk factor management, and reducing inflammation would be an important strategy for this population.
The underlying cause of Chronic Inflammation is something called Metabolic Syndrome. What is it? Metabolic syndrome is a problem that often occurs in modern industrialized society when as people reach middle age they don’t get as much exercise, eat too many carbohydrates and sugars, and gain weight. These things cause increases in triglycerides and blood pressure which increases the risk of heart disease, and also, you guessed it…arthritis. The resulting weight gain puts additional pressure on the joints, but more importantly, metabolic syndrome causes low level, whole body inflammation as well as other chemical changes that act toward arthritis like throwing lit matches into a dry forest.
If you fall into this category, and a good clue is that you can’t function without NSAIDS like Motrin, Aleeve, Mobic, Clebrex, etc. there are things you can do to change the direction of things. Switching to a low glycemic eating plan, increasing your exercise, and replacing your NSAIDS with supplements like fish oil, Glucosamine and Chondroitin, resveratrol, and curcumin, will go a long way to getting your body back on track. It’s well known that good quality, concentrated EPA fish oil is particularly good at reducing inflammation. However, a recent study showed that it also contains resolvin, which increases the signal in your body to stop inflammation and turn on healing. Curcumin is useful for pain, as an anti-inflammatory and recent studies have shown its anti-oxident properties. Studies have shown that Resveratrol stimulates the SIRT-1 gene, with all of it’s benefits to everyting from cartilage to diabetes to heart disease. Glucosamine and Chondroitin have been shown in studies to improve pain, reduce cartilage loss, reduce inflammation and have none of the cardiac risk of NSAIDS.
The upshot? The good news is if you have arthritis that needs treatment, you can try regenerative treatments like precise image-guided injections of your own stem cells and platelets. However, given the arthritis heart attack association, you also need to view this as a new cardiac warning sign! So arthritis now means a new commitment to lifestyle changes that can actually help your heart rather than medication which will mask things and introduce a whole slew of side effects!
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…