Heart disease doesn't develop overnight, and it isn't caused by cholesterol alone. Increasingly, researchers understand cardiovascular disease as an inflammatory process that unfolds silently over years. When inflammation persists, it can damage blood vessel walls, encourage plaque buildups, and make existing plaque more likely to rupture, triggering heart attack or stroke. 

Chronic Inflammation and the Progression of Disease 

The immune system’s response to injury, inflammation is an important reaction that allows the body to protect itself. But when inflammation becomes chronic, the immune system may begin to attack itself, damaging the walls of blood vessels and leading to hardening of the arteries.

“When I spot someone with obvious signs of metabolic syndrome—usually a middle-aged person with a big stomach—I know that a lot of inflammation is going on,” says Hyla Cass, MD, at UCLA School of Medicine, “and that he or she has a high risk of heart disease and high blood pressure,” which strains both the heart and blood vessels.

“Fat cells in the belly, also called visceral fat, create a lot of inflammation,” she continues. “If you’re insulin resistant or diabetic, the state of high insulin and high blood sugar is creating even worse inflammation,” forming “plaques in the twists and turns of the blood vessels that feed the muscular walls of the heart. This, in turn, drastically increases the risk of having a heart attack.” 

Other factors increase risk too. LDL (lousy) cholesterol works to spackle and fill plaques. If it’s oxidized by free radicals, the inflammatory process continues, causing even more damage and inflammation in a vicious circle.

“Keep in mind that high levels of LDL, triglycerides, and other bad fats in the blood are likely to be effects of the inflammation that is the real direct cause of heart disease,” Dr. Cass adds.

Dietary Habits That

Lower Inflammation

For starters, have a simple lab test that measures C-reactive protein (CRP), a marker for heightened inflammation in the body. Elevated CRP has been linked to greater risk for heart attack, stroke, and peripheral vascular disease.

Next consider eating an anti-inflammatory diet like the popular Mediterranean diet. This healthy eating pattern emphasizes fruits, vegetables, olive oil, and limited meat eating and has been shown to have a positive impact on heart health, diabetes, arthritis, cancer, and sleep apnea.

Choose omega-3-rich fish (salmon, sardines, and mackerel) and grass-grazed meat if you eat animal protein. Replace saturated and trans fats with vegetable protein such as soy, which is high in fiber and nutrients. Consume more antioxidant-rich, brightly colored fruits and vegetables. One study suggests that substances in tomatoes can halt or even reverse oxidative stress and help protect vascular tissues, for example. 

“Think of sugars and refined grains as slow-burning fires” that stoke inflammatory processes in the body “and omega-3 fats as cool, quenching water,” explains Dr. Cass.

Enjoy fiber-rich whole grains, linked to a 40 percent lower risk for coronary heart disease. They’re high in heart-healthy fiber, B vitamins like folate and B6, magnesium, and vitamin E. 

Research validates the link between a healthy diet with lower LDL and total cholesterol, triglyceride levels, and higher HDL (good cholesterol), all of which protect the heart.

Do you have food sensitivities? If so, eliminating allergens can help reduce inflammation.

Season your food with anti-inflammatory herbs and spices (curry, garlic, ginger, rosemary, turmeric) rather than salt, which is linked to high blood pressure. “Sip green tea once or twice a day,” Dr. Cass also suggests, since this tea is rich in antibacterial and antioxidant ingredients. Indulge in a little dark chocolate, an excellent source of antioxidants that may even lower blood pressure.

Or a handful of nuts: Flavonoids in almonds help prevent LDL oxidation in experimental research.

Added Protection

An anti-inflammatory lifestyle extends far beyond diet. Exercise, restorative sleep, and stress management all play essential roles in cardiovascular health. Even short, 10-minute workouts throughout the day, most days of the week, help fight heart disease. 

A number of studies show that nutritional supplements and herbs—particularly those high in antioxidants and anti-inflammatories—help fight cardiovascular disease and hypertension. In addition to omega 3s, consider coenzyme Q10 for energy (particularly useful for people on statins) and magnesium to help support blood pressure.