Systemic Inflammation Raises Heart Risk by 43%, Largest Study Links It to Lifestyle

A large-scale study published in the European Journal of Preventive Cardiology reveals that chronic inflammation throughout the body—measured through a blood marker called glycoprotein acetyls (GlycA)—is closely linked to changes in heart structure and an increased risk of major cardiovascular events. The analysis of 488,079 UK Biobank participants is one of the strongest pieces of evidence connecting systemic inflammation to heart health.

The researchers found that individuals with the highest GlycA levels were 43% more likely to experience a heart attack, stroke, or death from cardiovascular disease compared with those with the lowest levels. This figure far exceeds the risk estimates from traditional factors such as LDL cholesterol alone. In addition, high GlycA levels were also associated with smaller left ventricular volume, thickening of the heart wall, and impaired diastolic function—all early markers of heart failure.

What sets this study apart from previous research is its comprehensive approach: it not only examined the biomarker but also linked it to environmental and genetic factors. Smoking, depression, visceral (abdominal) fat, and android fat distribution (abdomen, chest, upper body) consistently raised GlycA levels. Conversely, regular physical activity, a healthy diet, and higher socioeconomic status were associated with lower inflammation levels.

"In clinical practice, I view GlycA as one piece of the puzzle, alongside ApoB or LDL cholesterol, blood pressure, blood sugar, visceral obesity, smoking status, and cardiovascular history. It is a risk marker, not a diagnosis or a standalone treatment target," said Michelle Routhenstein, a preventive cardiology dietitian at EntirelyNourished, who was not involved in the study.

Dr. Cheng-Han Chen, an interventional cardiologist at MemorialCare Saddleback Medical Center, added that the findings align with the broad understanding that persistent inflammation contributes to the cardiovascular disease process. "People with the highest GlycA levels had a 43% higher risk of major cardiovascular events. That is a meaningful difference and adds to the evidence that GlycA can provide useful information about cardiovascular risk," he said. However, he cautioned that the study does not prove causation, so further research is still needed to confirm GlycA's role as a prognostic biomarker.

For Indonesia, these findings are relevant given the rising prevalence of heart disease and the increasingly common sedentary lifestyle in cities. Riskesdas 2018 data show that heart disease is one of the leading causes of death, with high rates of risk factors such as smoking, central obesity, and lack of physical activity. This study underscores that lifestyle intervention—not just cholesterol-lowering drugs—must be the main pillar of prevention.

Routhenstein emphasized that cardiovascular risk is not a battle between genes and lifestyle. "Our genes may influence how strongly the body responds to abdominal fat, smoking, diet, stress, or inactivity, but genes do not determine our future on their own," she explained. "The factors we can change through science-based nutrition—diet quality, physical activity, smoking cessation, sleep, blood pressure, blood sugar, and cholesterol management—remain beneficial for everyone, regardless of genetic background."

With these findings, the question going forward is whether GlycA measurement will be adopted in routine screening in Indonesia and other countries, and how health systems can integrate inflammatory markers into more personalized prevention strategies. If proven effective, this step could revolutionize how we predict and prevent heart disease long before symptoms appear.