Powerful evidence that obesity stimulates inflammation in turn increasing the risk of heart failure

May 12, 2008

     Scientists report the latest findings from MESA (Multiethnic Study of Atherosclerosis [an ongoing study]) - obesity is associated with long-term inflammation of the heart possibly leading to congestive heart failure. The analysis conducted by cardiology specialists at Johns Hopkins University and other institutions involved 6,814 MESA participants who were 45 to 84 years of age upon recruitment between 2000 and 2002. MESA researchers plan to follow the subjects until 2012.

     Of the 79 participants who developed congestive heart failure after an average observational time of four years, 44 percent were obese. Obese subjects had higher levels of inflammatory proteins fibrinogen, C-reactive protein, and interleukin-6 compared with non-obese participants. Those with almost double the normal level of interleukin 6 had an 84 percent greater risk of developing heart failure. Those with almost triple the normal level of C-reactive protein had a 36 percent greater risk than those with lower levels. The researchers also found a link between elevated inflammation-associated proteins and metabolic syndrome.

     “Our results showed that when the effects of other known disease risk factors - including race, age, sex, diabetes, high blood pressure, smoking, family history and blood cholesterol levels - were statistically removed from the analysis, inflammatory chemicals in the blood of obese participants stood out as key predictors of who got heart failure,” lead researcher João Lima, MD, who is a professor of medicine and radiology at the Johns Hopkins University School of Medicine stated in an interview.

     Study coauthor Hossein Bahrami, MD added, “The basic evidence is building the case that inflammation may be the chemical route by which obesity targets the heart, and that inflammation may play an important role in the increased risk of heart failure in obese people, especially those with the metabolic syndrome.” The study result is published in the May 6, 2008 issue of the Journal of the American College of Cardiology.

Note;The Multi-Ethnic Study of Atherosclerosis (MESA) is a medical research study involving more than 6,000 men and women from six communities in the United States. MESA is sponsored by the National Heart Lung and Blood Institute of the National Institutes of Health. Currently there have been 100 scientific papers based on results of MESA.

Participants in MESA are seen at clinics in the following universities:

Enbrel gets FDA “Black Box” warning about dangerous infection risk

     The arthritis and psoriasis drug Enbrel now has a "black box" warning about the risk of serious infections that may lead to hospitalization or death. Enbrel is used to treat rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis. It already carried a warning about infection risk. Now, those risks appear in a "black box" warning, the FDA's sternest warning.

     The new black box warning notes that infections seen in patients treated with Enbrel have included rare cases of tuberculosis. The warning recommends teaching patients taking Enbrel about infection symptoms, monitoring them for infection during and after treatment with Enbrel, and screening them for tuberculosis before and during Enbrel treatment. The biologic drugs Remicade and Humira, which are used to treat rheumatoid arthritis, already have boxed warnings about tuberculosis risk.