Higher levels of a blood marker associated with chronic inflammation have been linked to changes in heart structure and a greater risk of serious cardiovascular events, according to a large study.

The marker, called glycoprotein acetyls, or GlycA, may help researchers understand how persistent, low-grade inflammation affects the heart. However, experts stress that the findings show an association rather than proof that elevated GlycA directly causes heart attacks, strokes or heart failure.

“The new study supports the view that inflammation is closely connected with other recognised risk factors. It may form part of a wider process linking smoking, abdominal fat, psychological distress, poor diet and inactivity with heart problems”

Published in the European Journal of Preventive Cardiology, the study analysed data from 488,079 participants in the UK Biobank. Researchers examined GlycA levels alongside heart structure, heart function, lifestyle habits, socioeconomic circumstances and genetic factors.

People with higher GlycA levels were more likely to have a smaller left ventricle. This is the heart’s main pumping chamber, responsible for sending oxygen-rich blood around the body.

Higher levels were also associated with thicker heart walls and reduced diastolic function. Diastolic function describes the heart’s ability to relax and fill with blood between beats. If this process becomes impaired, the heart may struggle to fill properly, even when its pumping strength initially appears normal.

“Inflammation may also worsen insulin resistance, high blood pressure and abnormal cholesterol. These conditions can place additional strain on the heart and increase the likelihood of cardiovascular disease”

These changes may develop before noticeable symptoms. Over time, they can contribute to heart failure, abnormal heart rhythms and other cardiovascular complications.

The researchers also found a relationship between higher GlycA levels and major adverse cardiovascular events, known as MACE. These included heart attacks, strokes and heart failure.

Participants with the highest GlycA levels had a 43% greater risk of experiencing a major cardiovascular event than those with the lowest levels.

Although this difference is important, GlycA should not be viewed as a diagnosis. Cardiovascular risk depends on many factors, including age, blood pressure, cholesterol, diabetes, smoking, kidney health, physical activity, family history and previous heart disease.

“One of the strongest associations involved fat around the trunk. Higher GlycA levels were more common among people with greater amounts of abdominal and upper-body fat”

Experts describe GlycA as a possible risk marker rather than a treatment target. A raised level may indicate increased inflammatory activity, but it cannot show precisely why inflammation is present or determine which treatment a person needs.

It is also not yet known whether lowering GlycA would reduce the risk of cardiovascular disease. Further research is needed to establish whether the marker provides information beyond standard measurements such as low-density lipoprotein cholesterol, apolipoprotein B, blood pressure and blood sugar.

GlycA reflects changes in several blood proteins involved in inflammation. Unlike some inflammatory markers that rise quickly during an infection or injury, GlycA is often considered an indicator of longer-term inflammatory activity.

Chronic inflammation can remain unnoticed. A person may have no obvious symptoms while inflammatory processes affect the blood vessels, heart muscle and metabolism.

Researchers estimate that around 34% of adults in the United States alone have systemic inflammation. However, estimates vary depending on how inflammation is defined and measured.

“Central weight gain is often more concerning for heart health than body weight alone. Two people with a similar body mass index may have different cardiovascular risks depending on where their body stores fat”

Scientists are still working to understand precisely how persistent inflammation affects the heart. Possible mechanisms include damage to the inner lining of blood vessels, increased arterial stiffness and changes in the way the heart muscle uses energy.

Inflammation may also worsen insulin resistance, high blood pressure and abnormal cholesterol. These conditions can place additional strain on the heart and increase the likelihood of cardiovascular disease.

The new study supports the view that inflammation is closely connected with other recognised risk factors. It may form part of a wider process linking smoking, abdominal fat, psychological distress, poor diet and inactivity with heart problems.

One of the strongest associations involved fat around the trunk. Higher GlycA levels were more common among people with greater amounts of abdominal and upper-body fat.

Visceral fat, which builds up deep inside the abdomen around the internal organs, is particularly active biologically. It can release substances that promote inflammation and interfere with the body’s response to insulin.

This may help explain why central weight gain is often more concerning for heart health than body weight alone. Two people with a similar body mass index may have different cardiovascular risks depending on where their body stores fat.

Smoking was also associated with higher GlycA levels. Tobacco smoke promotes inflammation, damages blood vessel walls and contributes to the build-up of arterial plaque. It can also make blood more likely to clot, increasing the risk of heart attack and stroke.

Psychological distress was another factor linked with elevated GlycA. Depression and prolonged stress may influence inflammatory activity directly. They can also affect sleep, food choices, physical activity, alcohol use and smoking.

The relationship is therefore complex. Emotional distress may affect cardiovascular health through several biological and behavioural pathways at the same time.

Socioeconomic circumstances were relevant as well. Lower socioeconomic status was associated with higher GlycA levels, while higher socioeconomic status was linked with lower levels.

This does not mean that socioeconomic position is a biological diagnosis. Social and economic conditions can influence access to nutritious food, healthcare, stable housing, safe places to exercise and adequate rest. These factors may affect inflammation and heart health over many years.

The researchers found more encouraging associations involving physical activity and diet. People who reported higher levels of physical activity generally had lower GlycA levels. Healthier dietary patterns were also linked with lower concentrations.

Regular exercise can improve blood pressure, blood sugar regulation, cholesterol levels, fitness and body composition. It may reduce inflammatory activity even when it does not produce major weight loss.

A heart-supportive diet commonly includes vegetables, fruit, pulses, wholegrains, nuts, seeds, fish and unsaturated fats. Reducing highly processed foods, excess salt, added sugar and processed meats may also support better metabolic health.

These habits are beneficial regardless of GlycA levels. People do not need an inflammation test before making changes that can reduce established cardiovascular risks.

Researchers also examined whether genetics affected the relationship between inflammation and environmental exposures. They found that genetic susceptibility appeared to modify this association.

A person’s inflammatory profile may reflect inherited characteristics as well as diet, exercise, smoking, body composition, stress and other environmental influences. Some people may be more biologically sensitive to certain exposures than others.

However, genetic risk does not determine an individual’s future. Cardiovascular disease usually develops through overlapping influences rather than a single inherited cause.

This is an important message because people cannot change their DNA. They can, however, take steps that may improve blood pressure, cholesterol, blood sugar, fitness, sleep and body composition.

Stopping smoking remains one of the most effective ways to lower cardiovascular risk. Regular physical activity, a balanced diet and appropriate medical care can also help. Treatment for high blood pressure, diabetes or high cholesterol may provide additional protection when needed.

Experts advise against interpreting one inflammation measurement in isolation. GlycA should be considered alongside cholesterol-related markers, blood pressure, blood sugar, waist measurements, smoking status, physical activity and personal or family history.

It is also important to distinguish chronic inflammation from short-term immune responses. Inflammation is a normal defence mechanism that helps the body respond to infection and injury. Problems may arise when inflammatory activity remains elevated for long periods without an immediate threat.

The study has important strengths, including its large sample size and access to detailed health information. Nevertheless, it was observational. Researchers could identify patterns, but they could not prove cause and effect.

The study showed that GlycA, lifestyle factors and cardiovascular outcomes were related. It did not show that increasing or lowering GlycA directly changes the likelihood of heart disease.

Some lifestyle information was also based on participant reports, which may be affected by memory or reporting errors. In addition, UK Biobank participants may not represent the entire population because people who join large health studies can differ from those who do not.

The findings should therefore be viewed as an important research development rather than an immediate change to clinical practice.

GlycA may eventually help identify people whose cardiovascular risk is not fully captured by standard tests. It could also help scientists study how inflammation, genetics and lifestyle interact. Before that happens, further research must determine whether the marker improves risk assessment and whether changing it improves health outcomes.

For now, the practical message is clear. Persistent inflammation is associated with poorer heart health, but people do not need a GlycA test to benefit from established preventive measures.

Avoiding tobacco, staying active, eating a balanced diet, managing blood pressure and cholesterol, controlling blood sugar and seeking help for psychological distress can all help with better GlycA level and support cardiovascular health.

GlycA may become a useful piece of the heart-health puzzle. It is not the whole picture, and it is not currently a diagnosis or treatment target on its own.