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  • Inflammation: Joint vs CVD

    Both cardiovascular disease and joint diseases such as Rheumatoid and Osteo arthritis check the blood CRP for Inflammation.

    So then why do NSAIDs lower CRP in a productive way for joints and this. reduction in inflammation increases CVD risk?

  • #2
    Tom, you have any ideas?

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    • #3
      I read your title as Inflammation: Joint or CBD

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      • sthubbar
        sthubbar commented
        Editing a comment
        rich, now that you have reread the title any thoughts? I am concerned because, since 2013, I have suffered from idiopathic joint pain. Therefore I take a plethora of nutraceuticals to manage this. Some of these are often compared to NSAIDs which supposedly make CVD worse.

        So, I'm confused if inflammation is bad for join disease and bad for CVD, then why do medications like NSAIDs that reduce inflammation help joint disease and make CVD worse? How about other anti-inflammatories such as COX-2 inhibitors or the above-mentioned neutraceuticals?

        Just looking for some help to resolve this paradox.

        Thanks.

    • #4
      I can't say that I have read extensively on NSAIDs. Here is what WebMD says on NSAIDs: "Aspirin as we know from many, many studies, is protective against heart attacks," he says. Aspirin prevents platelets from clumping together, which prevents the formation of dangerous clots that can block a vessel and cause a heart attack or stroke. The non-aspirin NSAIDs work on that enzyme, too, but also affect another enzyme that promotes clotting. That can lead to heart attacks and strokes." For people with very serious joint disease/arthritis, then they need to be aware of the risk and decide if the NSAIDs they are taking are worth the risk. For some people, the answer might well be yes.

      From what I do know, I think that frequent use of many NSAIDs can be bad for the kidneys as we age. I do take a baby aspirin daily myself, but I only use other NSAIDs infrequently. I know that there is even a lot of controversy about aspirin, and Dr. Brewer made a video on this.

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      • sthubbar
        sthubbar commented
        Editing a comment
        Tom, thank you for the response. This is the same information I find. The odd thing in that whole quote is that there is no discussion of the NSAID's ability to reduce inflammation in reference to CVD, it just talks about clotting. Is maybe the inflammation for joints different than the inflammation for CVD? What is CVD inflammation? Is that really the intermedia thickness so not really inflammation or is there something else about inflammation that is bad?

    • #5
      Inflammation is a huge topic, and even cardiovascular inflammation has had substantial advances over the past decade or two. While our immune system is absolutely essential for us to stay alive, there are obviously times when chronic inflammation drives disease. Dr. Brewer and other wellness doctors look at MPO and Lp-PLA2 levels as markers of chronic cardiovascular inflammation vs. hs-CRP which can be caused by many issues including arthritis. If your test results show high sustained hs-CRP levels, you likely have some kind of chronic disease process going on. Some doctors are starting to look at the inflammasomes as one of the root inflammation markers, but no widely available tests are out yet to my understanding. If you are interested in learning more about inflammation, I recommend reading the below article as a start. It is one of a series on inflammation. The authors spent a lot of time and effort to compile information without the usual hand waving, click-baiting approach on many health websites. I learned a lot from reading up on various topics at this website. Inflammation is one of the most important topics as keeping inflammation under control as we age is key to living well into old age.

      There are some common pathways for inflammation as it starts up, but different types of problems result in different immune responses. For cardiovascular disease the immune system produces MPO and Lp-PLA2 to kill/break down what the immune systems senses shouldn't be in the intima-media spaces in large amounts (LDL particles and crystallized cholesterol in particular). I am not aware that there is an equivalent at the joint for arthritis.

      http://www.anti-agingfirewalls.com/2016/11/
      Last edited by Tom; 05-24-2019, 01:03 AM.

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      • sthubbar
        sthubbar commented
        Editing a comment
        Tom, ok thanks for the information. The article was too long for me to follow. I have done extensive blood work and I think those markers are in there and ok. I'll share them once all the results are in.

    • #6
      sthubbar,

      Ok, I think that this excerpt from the Arthritis Foundation webpages provides a more detailed answer to your question. Why the High Risk if You Have RA?

      Daniel H. Solomon, MD, a professor at Harvard Medical School in Boston and a leading researcher on cardiovascular disease and RA, says the inflammatory processes in RA and heart disease are very similar. In RA, inflammation attacks the synovium — the thin layer of tissue that lines your joints — but it can move to other organs, including the heart. One of the possible victims is the endothelium, the innermost layer of blood vessels. Inflammation causes damage to the blood vessel lining, and plaque builds up. This fatty deposit narrows arteries, raising blood pressure and reducing the flow of blood to your heart and other organs.

      In a 2015 study in Nature Reviews Rheumatology, British investigators reported that people with RA are more likely to have atherosclerosis than the general population and that they develop it at a faster rate. Plaque is also more brittle and prone to rupture in RA, and more likely to cause a heart attack or stroke. In fact, the risk of ischemic stroke, resulting from a clot in an artery supplying blood to the brain, is nearly doubled in people with RA. Atherosclerosis starts early in the course of RA — often before there are joint symptoms — and progresses rapidly after RA is diagnosed.

      Inflammation doesn’t only damage the heart’s arteries. It affects veins, too, increasing the risk of deep vein thrombosis (DVT) and pulmonary embolism — blood clots in the legs or lungs. A 2012 Mayo Clinic study found a three-time greater risk of DVT in people with RA and a more than four-times greater risk of life-threatening pulmonary embolism.

      Some research, including a 2015 Mayo Clinic study published in BioMed Research International, suggests that people with RA have a significantly increased risk of atrial fibrillation (AF) — an irregular heartbeat that can increase stroke risk fivefold. The study also reported an association between diastolic dysfunction, an abnormality in how the heart fills with blood, and AF, and that patients with RA are known to have increased prevalence of diastolic dysfunction.

      Inflammation of the two-layered sac that surrounds the heart known as the pericardium is also more common in patients with RA. The inflamed sacs rub against each other, causing sharp, intense chest pain.

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      • sthubbar
        sthubbar commented
        Editing a comment
        Tom, so there is the paradox. If we take medication to reduce the severity of RA, which should reduce the global inflammation, including in the arteries and heart, somehow this medication increases the risk of CVD. So is it simply because of the increased blood clotting that is mentioned above? I feel like I'm just guessing, otherwise, it seems logical that reducing joint inflammation should reduce artery and heart inflammation and therefore reduce CVD risk.

    • #7
      While the lowering of hs-CRP would be helpful in cardiovascular disease, I am not sure that it would significantly suppress the immune response to the LDL particles and especially crystallized cholesterol in the intima-media space. That along with the increased blood clotting is probably the answer based upon what is known now.

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      • sthubbar
        sthubbar commented
        Editing a comment
        Tom, ok thanks.

    • #8
      Maybe joint or CBD is your answer!

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