This is a continuation of my discussion about the Complete Cardiometabolic Assessment.  These inflammation markers specifically address inflammatory processes in the blood vessels which is the beginning of atherosclerosis.


Myeloperoxidase is an antimicrobial enzyme that is released at sites of inflammation to kill invading bugs. But, it can also damage the lining of blood vessels at high levels and eventually cause atherosclerosis. High levels in the blood is a strong indicator of unstable plaques and risk of cardiovascular disease.


C-reactive protein is a marker of inflammation which can be caused by infections,  trauma, surgery, malignancy, oral estrogens, smoking, and chronic inflammatory conditions. Since there are several types of inflammation that could cause it, we need other markers to signal CV risk, but it is a strong predictor of CVD and stroke, especially in those with metabolic syndrome. If there is a clear infection or injury, wait at least 2 weeks to test CRP to avoid false positive risk assessment.

Lowering CRP is done with exercise, increasing fruits and vegetables in diet, omega 3 fatty acids, fiber, anti-inflammatory spices, statins, niacin, and aspirin.


Fibrinogen is a precursor of fibrin, which is the major component of blood clots. This is the earliest stage of atherosclerosis plaques and is associated with risk of heart attack and stroke.  Fibrinogen levels can be reduced by smoking cessation, exercise, estrogens, and fibrates, a class of drugs used to decrease LDL cholesterol.


Vitamin D is an important immune modulator and has anti inflammatory, antimicrobial,  and antihypertensive properties. Vitamin D also protects from insulin resistance. A deficiency in Vitamin D has been associated with a significantly increased risk in cardiovascular events.


Homocysteine reflects a deficiency in Vitamin B12 and foliate and is associated with increased inflammation and oxidative stress. It can, in itself, lead to vascular injury and blood clots, thus cardiovascular disease.


Low levels of these vitamins can cause high homocysteine, as such are risk factors for cardiovascular disease and low bone density. Sufficiency can prevent stroke and cognitive decline.

My next post will explore the much less known, and early detectors of insulin resistance and pre diabetes which also pose cardiovascular risk.