In addition to the resource below, please see the excellent brief introduction to today’s resource, New ACC Scientific Statement Details Role of Inflammation in CVD, Sep 29, 2025;
“The evidence linking inflammation with ASCVD is no longer exploratory but is compelling and clinically actionable,” write the authors, led by Writing Committee Chair George A. Mensah, MD, FACC. “The time for taking action has now arrived.”
Published in JACC, the Statement includes specific recommendations for screening, evaluation, and CVD risk assessment; inflammatory biomarkers in cardiovascular imaging; inflammation inhibition in behavioral and lifestyle risks; and anti-inflammatory approaches in primary and secondary prevention as well as in heart failure and other cardiovascular diseases.
Among the key takeaways:
- High-sensitivity C-reactive protein (hsCRP) is an inexpensive and widely available blood test. While there has been debate within the medical community regarding the utility of hsCRP, this statement details the data confirming its value in clinical decision making in primary and secondary prevention.
- In patients with known CVD, hsCRP level is at least as predictive of future events as LDL cholesterol levels, even in patients treated with statin therapy.
- The important role of lifestyle interventions to reduce systemic inflammation is emphasized, including regular exercise (at least 150 minutes/week), Mediterranean or DASH Diet, and intake of omega-3 fatty acids, including two to three meals per week of fatty fish high in EPA and DHA. This advice aligns with lifestyle management recommendations in the 2025 ACC/AHA High Blood Pressure Guideline
The Statement also discusses current challenges and opportunities based on the new evidence, exploring topics like the advancing field of cardioimmunology and areas for further research, such as the interplay between inflammation and key physiological systems, the role of novel special pro-resolving bioactive lipid molecules in promoting the resolution of inflammation and CVD risk reduction, and more.
The authors close with a call for action to “embrace anti-inflammatory interventions in patients with established ASCVD” and for clinical practice guidelines that implement “broad screening of primary and secondary prevention patients for hsCRP, in combination with LDL cholesterol.” Additionally, they note: “The time is also ripe for the development of strategies to promote increased physician awareness of the crucial role of inflammation in CVD and accelerate the adoption of evidence-based, guideline-directed anti-inflammatory therapy through dissemination and implementation research.”
Today I review, link to, and excerpt from Inflammation and Cardiovascular Disease: 2025 ACC Scientific Statement: A Report of the American College of Cardiology. J Am Coll Cardiol. 2025 Sep 29:S0735-1097(25)07555-2. doi: 10.1016/j.jacc.2025.08.047. Online ahead of print. [PubMed Abstract] [Full-Text HTML] [Full-Text PDF].
All that follows is from the above resource.
Abstract
The crucial role of inflammation in the pathogenesis and clinical outcomes of cardiovascular disease (CVD) has recently gained increased attention. In particular, residual inflammation, measured with high-sensitivity C-reactive protein (hsCRP) remains strongly predictive of recurrent events, even in statin-treated patients. Similarly, elevated hsCRP in apparently healthy individuals identifies a higher-risk group in whom statin therapy significantly reduces the risk of first major CVD events even if LDL-cholesterol is normal. This report provides an updated understanding of the role of chronic, low-grade inflammation in CVD and highlights new seminal research findings, especially in atherosclerosis, myocardial infarction, heart failure, and pericarditis. Consensus recommendations are summarized for screening, evaluation, and CVD risk assessment; inflammatory biomarkers in cardiovascular imaging; inflammation inhibition in behavioral and lifestyle risks; and anti-inflammatory approaches in primary and secondary prevention as well as in heart failure and other CVDs. This report also addresses current challenges and future opportunities. For example, it cautions that not all trials of anti-inflammatory therapy in secondary prevention have been successful and such trial evidence is needed before broad recommendations for other agents can be made. Additionally, in successful trials, the interplay between inflammation and key physiological systems often remains incompletely examined. Another promising area of research is the role that novel special pro-resolving bioactive lipid molecules play in promoting the resolution of inflammation and CVD risk reduction. In aggregate, the evidence linking inflammation with atherosclerotic CVD is no longer exploratory but is compelling and clinically actionable. The time for taking action has now arrived.
Keywords: ACC Scientific Statement; cardiovascular disease; high-sensitivity C-reactive protein; inflammation; omega-3 fatty acids; prevention.
Copyright © 2025 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
