By Andrea Gawrylewski, Chief Newsletter Editor, |
April 14, 2026
For decades, four big risks for heart disease have been the focus of cardiology: hypertension, smoking, high levels of “bad” LDL cholesterol and type 2 diabetes. But now, research is shifting to study the role of chronic inflammation. Chronic inflammation, or the prolonged and damaging state of immune system activation, may accelerate cardiovascular problems. In 2023, the FDA approved an existing drug for gout, colchicine, for the treatment of heart disease; a clinical trial showed that those who took it had 30 percent less chance of cardiac incidents, especially when combined with statins.
Why this matters: Nearly a quarter of people admitted to hospitals for heart attacks don’t have any of the four classic risk factors. In fact, a 2023 analysis found that hospitalized acute coronary patients without any of the four hazards were 57 percent more likely to die compared to those who had at least one. This medical mystery means that for more than 200,000 people who die of cardiac disease every year, doctors don’t know why.
How it works: Inflammation is the body’s built-in alarm system, and activates when the immune system senses that something untoward is happening. The body recruits immune cells to the scene, where they launch an all-out attack against any unwelcome intruders and cells they’ve infected. Sometimes this process doesn’t wane or shut off and starts harming the body’s healthy tissues. Doctors measure someone’s level of inflammation by blood levels of C-reactive protein, which is a molecule that signals inflammation.
Cholesterol, a fatty compound produced primarily in the liver (above), can form jagged, needlelike crystals that tear artery walls and trigger an inflammatory reaction, blocking the flow of blood. Steve Gschmeissner/Science Source
New treatments: Colchicine, a treatment for gout, reduces inflammation, but is not without its skeptics (results of several clinical trials have been mixed). And several other trials are underway to test if blocking other immune system responses that drive inflammation can improve heart outcomes. One is a treatment that stymies interleukin-6, another of the immune system’s chemical messengers which can drive harmful vascular processes.
Join a special online event this Thursday. Our health editors Tanya Lewis and Josh Fischman will be discussing the shifting focus on inflammation in cardiology. Learn more and register here.
(Sources: Science American)
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