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Doctor’s Tip: Inflammation — Are your arteries on fire?

Dr. Greg Feinsinger

This is the second-to-last column in a series about the major causes of heart attacks — our number one killer.

Prevention of all these causes includes a healthy lifestyle. The following is what a reader emailed after the recent column about prevention and reversal of type 2 diabetes (used with his permission):

“I went into the ER in A-fib, A1C 7.6 (measures average blood sugar over the previous three months, normal < 5.7) and blood sugar 760 (extremely high, normal less than 93). I was a 61 years of age male, 6’2,” 235#. Nine months later I am 180#, A1C 4.9-5.2, blood sugar of 85-90, all through diet and exercise! I wish more folks knew what was coming from an abusive lifestyle. I pretty much (90%) have adjusted to a plant-based diet, abstain from alcohol, refuse sugary drinks or sugar infused products, never have I felt better! Keep providing the info and let’s hope it sinks in!”



The Bale-Doneen Method is recognized nationally and internationally as one of the most effective methods of heart attack prevention there is. It basically involves the following: 1. Determine if someone has atherosclerosis (hardening-of-the-arteries) through studies such as carotid IMT and coronary calcium scoring. 2. If someone has atherosclerosis, Bale and Doneen advise looking for and treating the inflammation that caused the plaque to form. 3. They also feel it’s imperative to do detective work to find and treat inflammation that can cause plaque to rupture and cause a heart attack.

ACUTE INFLAMMATION occurs when an injury happens, is necessary for healing, and is manifested by swelling and redness. However, sometimes acute inflammation is harmful and can cause atherosclerotic plaque to rupture, resulting in a heart attack. An example is the 100,000 heart attacks that occur annually as the result of acute inflammation caused by influenza.



CHRONIC INFLAMMATION contributes to formation of arterial plaque. Frequent causes of chronic inflammation include obesity, hypertension, high cholesterol, prediabetes, diabetes, tobacco use, unhealthy diet, sedentary lifestyle, inflammatory diseases such as rheumatoid arthritis, sleep apnea, inadequate sleep, stress, chronic tooth or gum disease and certain genetic factors.

Following are blood tests that help determine if you have “fire in your arteries,” as Bale and Doneen put it:

• hsCRP (highly sensitive c-reactive protein) measures inflammation but is non-specific and can be elevated not only in arterial inflammation but also from conditions such as a viral infections, arthritis or even a hard workout.

• F2 isoprostane is elevated in people with an unhealthy lifestyle and is called the “lifestyle lie detector test.” It is elevated in people with an unhealthy lifestyle and also in over-exercisers such as ultra-marathoners and people who run repeated marathons.

• Fibrinogen is a marker of any type of inflammation including arterial inflammation.

• Microalbumin/creatinine urine ratio measures the health of the endothelial lining of arteries in the kidneys — which are very vascular organs. Men with a value of over 4 and women with a value of over 7.5 have triple the risk of a heart attack or stroke.

• Lp-PLA2 is an FDA-approved test that rises when atherosclerotic plaque in the walls of arteries becomes inflamed, making it likely to rupture and block an artery.

• Myeloperoxidase (MPO) is an FDA-approved test that is a biomarker of blood vessel inflammation and also vulnerable plaque (i.e. plaque that is likely to rupture and cause a heart attack or stroke). If elevated a search for dental inflammation is imperative.

A panel that includes all of these tests is available through Boston Heart Diagnostics, Cleveland HeartLab, Quest Diagnostics and LabCorp for less than $150 and is often covered by insurance.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market, and cooking classes. Call 970-379-5718 for appointment, or email gfeinsinger@comcast.net.


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