Cardiologist views modern problem of heart disease through evolutionary lens

A cardiology fellow from Duke University Medical Center believes the inflammatory processes hardwired in our immune systems became more powerful with human evolution and contribute to the significant burdens of atherosclerosis and heart disease in present day.

Three main things have threatened humans for most of their time on Earth, Haider Warraich, MD, explained in an interview with The Atlantic: infections, malnutrition and injuries or wounds.

The body’s reaction when it is bitten by a wild animal, for example, is to combat the wound with inflammation. White blood cells full of cholesterol fight off the infection but can deposit some of that cholesterol in blood vessels.

With too much inflammatory stimulation over time, plaques can build up and cause blockages leading to heart attacks and strokes.

“We don’t have the burden of infections, especially in higher-income countries, but what has happened is that we have been self-selected to have a very, very robust immune system,” Warraich said. “These very robust immune systems are in some ways like a post–Cold War nuclear arsenal, in which you don’t have that threat anymore, but these weapons are still lying around. That’s why we see all these autoimmune diseases, and also we see such a high prevalence of atherosclerosis.”

Warraich also pointed out “adaptive mechanisms” to stave off malnutrition—coupled with the overabundance of food now available—led to the current epidemics of obesity and diabetes.

Read the full interview below: