New Delhi: Persistent inflammation, caused by chronic stress from one's socioeconomic situation and lifestyle, could cause damaging structural changes in the heart, reveals a study.

Researchers, led by those at the UK's Imperial College London, analysed UK Biobank data from over 4,88,000 adults. Along with heart imaging and genetic data, a blood marker known as glycoprotein acetyls (GlycA) that measures inflammation was also looked at.

The findings, published in the European Journal of Preventive Cardiology, show that in addition to a higher risk of heart attack and stroke, those with higher levels of GlycA also showed more evidence of structural changes in their hearts, including thickened heart walls, smaller heart chambers and poorer heart filling.

The changes may develop quietly for years before progressing to heart failure, the researchers said.

"Chronic systemic inflammation is associated with reduced left ventricular volumes and increased cardiovascular risk in the community, with circulating cytokines and growth factors including IL-1 (Interleukin-1) and TNF (tumour necrosis factor) identified as potential mediators of these associations," the authors wrote.

Author Declan O'Regan, British Heart Foundation Chair of Cardiovascular AI at Imperial College London, said, "Our study, which is the largest of its kind, suggests that millions of people could be living with hidden inflammation, which is slowly changing their heart and causing long term damage -- increasing the risk of heart attack and stroke."

"Chronic inflammation is complicated, but we know it's tied to our health and driven by a range of lifestyle and economic factors -- meaning people may be at more risk just because of their surroundings, their economic status, their family's health and their lifestyle," O'Regan said.

Chronic inflammation, a long-term low-level activation of the body's immune system, has been linked with a range of diseases, including cancer and diabetes, and is increasingly recognised as a hidden driver of heart disease.

"But while tackling health inequalities remains an issue, there are things that we can do about inflammation, including reducing risk factors like smoking and obesity," O'Regan said.

The study found that people with persistently higher levels of inflammation -- the top 20 per cent -- faced a 43 per cent higher risk of heart attack and stroke, compared to those with lowest levels, even if they had no previously existing heart disease.

Further, "Higher GlycA levels were associated with reduced left ventricular indexed end-diastolic volume and stroke volume, with compensatory increased heart rate," the authors said.

Higher levels of inflammation were strongly associated with measures of socioeconomic disadvantage and psychological distress, as well as the more established risk factors including smoking and excess body fat.

The findings suggest that chronic inflammation may be one biological pathway through which everyday life stresses, including poverty and mental health issues can have biological effects that may increase cardiovascular risk, the researchers said.