| Doctors rethink key heart villain Inflammation may top cholesterol as the largest problem By Daniel Q. Haney-AP medical editor BOSTON — Worse than cholesterol? Hard to believe, perhaps, but the top health concern of millions of Americans is about to be trumped by what doctors say is an even bigger trigger of heart attacks. The condition is low-grade inflammation, which may originate in a variety of unlikely places throughout the body, including even excess fat. New federal recommendations are being written that will urge doctors to test millions of middle-aged Americans for it. The discovery of its surprising ill effects is causing a top-to-bottom rethinking of the origins and prevention of heart trouble. Doctors call it a revolutionary departure from viewing the world's top killer as largely a plumbing problem blamed on cholesterol-clogged arteries, the standard theory through the modern era of cardiology. "The implications of this are enormous," says Dr. Paul Ridker of Boston's Brigham and Women's Hospital. "It means we have an entire other way of treating, targeting and preventing heart disease that was essentially missed because of our focus solely on cholesterol." In the past year or two, experts say, the evidence has become overwhelming that inflammation hidden deep in the body is a common trigger of heart attacks, even when clogging in the arteries is minimal. Now the main question is: How aggressively should otherwise healthy people be tested to find and treat it? |
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