(BPT) - Millions of Americans will board planes and travel long distances this holiday season, many of them living with known heart disease, many others quietly carrying dangerous plaque they don't even know is there. And the risk most people are watching, cholesterol, is not actually the one most likely to trigger the life-changing event.

In most families, there is at least one person this applies to.

The most important and least discussed driver of atherosclerotic cardiovascular disease (ASCVD) progression is inflammation inside the artery wall, the cellular fire that makes plaque more unstable and more likely to rupture. That inflammatory risk shows up during travel.

Altitude changes, cabin pressure changes, noise and air pollution exposure, long stasis in seats, dehydration, sleep disruption: each of these are inflammatory stressors. When layered on an artery wall already primed by inflammation, the likelihood of a high-consequence cardiovascular event can rise.

"When planning holiday travel, particularly for people living with heart disease including ASCVD, the most crucial first step is to consult with your cardiologist to assess your individual risks," said Jimmy Kerrigan, M.D., FSCAI, FACC, assistant professor of Medicine at the University of Tennessee Health Science Center and interventional cardiologist at Saint Thomas Heart at Ascension Saint Thomas West in Nashville, Tennessee. "Once evaluated and with proper medication management - including packing your prescriptions and ensuring that you have adequate refills available - taking simple steps like frequent movement and hydration are key. Proactive planning is what turns potential risk into a special and safe journey."

Why inflammation matters

ASCVD develops when plaque builds and hardens arteries. The dangerous part is not the cholesterol itself. It is the inflammation inside the artery wall that makes plaque more unstable and more likely to rupture.

Environmental studies have shown that combined exposure to air pollution and transportation noise, two common realities of major holiday travel hubs, can raise arterial inflammation and increase cardiac event risk.

Air travel adds another layer: cabin oxygen is lower than sea level. A heart already pushing blood through narrowed arteries must work harder. Long periods of sitting during flights, long drives or train rides also raise the risk of deep vein thrombosis. Inflammation compounds that.

Inflammation can be measured and managed with your clinician

Three simple biomarkers can identify hidden vascular risk: LDL cholesterol, Lipoprotein(a) and high-sensitivity C-reactive protein (hs-CRP; an inflammation biomarker).

However, managing and reducing inflammation through an anti-inflammatory medication such as low-dose colchicine, 0.5 mg, can go a long way toward managing ASCVD and slowing the progression of cardiovascular disease. The once-daily oral tablet can be used in combination with a patient's current lipid-lowering medication and has been shown in clinical studies to reduce the risk of cardiac events by 31%.

Know your risk before you travel

A simple pre-holiday reality check can alter the trajectory of this season:

• Find out your inflammation level: ask your clinician about hs-CRP
• If you already have diagnosed ASCVD: talk to your clinician about your risk and your plan before you travel
• If you don't have ASCVD but you have a parent, sibling, partner or close friend who does: ask them if they know their inflammation number

For more information about inflammation and ASCVD risk, visit CVDInflammation.com.

Travel smart with ASCVD

With proper planning and medical clearance, many people with ASCVD can travel safely and comfortably. Consider the following:

• Consult your doctor: Before booking, speak with your healthcare provider to assess your fitness for travel and discuss your itinerary. You may need a note detailing your condition, medications and any implanted devices.
• Plan and pack medications carefully: Carry all medications, including extras for potential delays, in clearly labeled containers in your carry-on luggage.
• Stay hydrated and move frequently: Drink plenty of water and avoid excessive alcohol or caffeine. During long journeys, get up and walk around at least once an hour to reduce the risk of blood clots. For car travel, plan frequent stops.
• Consider compression socks: Your doctor may recommend compression stockings, especially for long-haul flights, to improve circulation.
• Research your destination: Look into medical facilities at your destination and check if your health insurance provides adequate coverage. Consider travel medical insurance that covers pre-existing conditions.
• Have a medical emergency plan: Carry a list of your medications and contact information for your doctor.

While flying with heart disease carries risks, they can often be managed with planning and precautions. Be sure to consult with your doctor before you travel, know your risk of a serious cardiovascular event such as a heart attack or stroke and be aware of warning signs - so this holiday can be both joyful and safe.

If you're a son or daughter reading this…

If you have a parent or grandparent with heart disease, send them this article. A simple conversation about inflammation could change their risk. One text could help protect someone you love.

Indication:

Low-dose colchicine, 0.5 mg is indicated to reduce the risk of myocardial infarction (heart attack), stroke, coronary revascularization, and cardiovascular death in adult patients with established atherosclerotic disease or with multiple risk factors for cardiovascular disease.

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