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Inflammation and Cardiovascular Disease Risk: A Case Study of HIV and Inflammatory Joint Disease

Faisal Rahman1, Seth S Martin1, Seamus P Whelton1

  • 1Division of Cardiology, Department of Medicine; Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.

The American Journal of Medicine
|December 23, 2017
PubMed

Insights

Chronic inflammation, seen in conditions like HIV and inflammatory joint diseases, significantly increases cardiovascular disease risk. Managing these conditions requires a comprehensive approach to mitigate vascular complications.

Area of Science:

  • Cardiovascular Medicine
  • Immunology
  • Rheumatology

Background:

  • Epidemiologic data confirms a link between chronic inflammation and elevated cardiovascular disease (CVD) risk.
  • Conditions with upregulated inflammatory pathways, such as Human Immunodeficiency Virus (HIV) and inflammatory joint diseases, present CVD risks comparable to or exceeding those of diabetes.

Purpose of the Study:

  • To highlight the critical need for clinicians to assess and manage cardiovascular risk in patients with chronic inflammatory conditions.
  • To utilize Human Immunodeficiency Virus (HIV) and inflammatory joint diseases as models for understanding inflammation's role in vascular disease and informing CVD prevention strategies.

Main Methods:

  • Review of existing epidemiologic data linking inflammation to cardiovascular disease.
  • Analysis of management strategies for chronic inflammatory diseases, emphasizing a multifaceted approach.
  • Consideration of clinical trial data, such as the CANTOS trial, supporting inflammation as a therapeutic target.

Main Results:

  • Chronic inflammatory disorders significantly contribute to vascular disease.
  • Current cardiovascular risk assessment tools may underestimate risk in patients with chronic inflammation.
  • Reducing inflammation is a viable therapeutic strategy for mitigating residual inflammatory risk for cardiovascular disease.

Conclusions:

  • A comprehensive management strategy for chronic inflammatory diseases is essential for cardiovascular risk reduction.
  • This includes addressing lifestyle factors, accurately assessing cardiovascular risk (with upward recalibration for inflammation), and intensifying risk factor treatment.
  • Targeting inflammation directly, as supported by trials like CANTOS, offers a promising avenue for preventing cardiovascular events in at-risk populations.

Keywords:
Cardiovascular diseaseHuman immunodeficiency virusInflammatory joint diseasesPreventionRisk

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