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A simple blood test can predict a woman’s risk of heart attacks and strokes decades later. The findings could change cardiovascular prevention, given that these diseases remain underdiagnosed and undertreated in women.
Researchers have successfully shown that a blood test based on the analysis of three known indicators can assess women’s cardiovascular risk over the next 30 years. A new, essential prevention tool.
Almost 4 times more likely to have a stroke!
For the study, researchers collected blood samples and medical information from 27,939 initially healthy American women. All began the study between 1992 and 1995 at an average age of 55 and were followed for 30 years. During that time, 3,662 study participants had a heart attack, stroke, surgery to restore circulation, or death from cardiovascular disease. The researchers assessed how high-sensitivity CRP, along with bad cholesterol (LDL cholesterol) and lipoprotein(a), or Lp(a), a lipid partly composed of LDL, singularly and collectively predicted these events.
The researchers found that, compared to women with the lowest levels of individual markers:
- Women with the highest hsCRP levels had a 70% higher risk of experiencing a major cardiovascular event;
- Women with the highest LDL-C levels had a 36% increased risk;
- Women with the highest levels of Lp(a) had a 33% higher risk.
Although hsCRP is the most powerful of the three biomarkers, all three have great importance. Women with high levels of all three markers were 2.6 times more likely to experience a major adverse cardiovascular event. This association was even stronger for stroke: Women with the highest levels were 3.7 times more likely to experience a stroke over the next 30 years.
A personalized and early indicator of cardiovascular risk
“These data should serve as a wake-up call for women.” said Julie Buring, study co-author, principal investigator of the WHS study and an epidemiologist in Brigham’s Division of Preventive Medicine.Waiting until women are in their 60s or 70s to start preventing heart attacks and strokes is doomed to failure“.
A view shared by lead author Dr. Paul Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital, who presented the results at the 2024 European Society of Cardiology Congress.To provide the best care for our patients, we need universal screening for inflammation, cholesterol, and lipoprotein(a), and we need it now. By doing so, we can target our treatments to each patient’s specific biological needs, fulfilling our long-held hope of providing truly personalized preventive care.“.
Act earlier to reduce risks
Each of the three risk factors can be modified through a combination of lifestyle changes and drug therapy. Many randomized trials have shown that reducing cholesterol and inflammation significantly reduces the risk of heart attack and stroke. In addition, several new drugs that significantly lower Lp(a) levels and second-generation anti-inflammatory agents are being tested to see if they can also reduce rates of clinical events.
These new data published in The New England Journal of Medicine strongly advocate for earlier and more aggressive targeted prevention, particularly in women for whom cardiovascular disease remains underdiagnosed and undertreated.
“While we should still focus on lifestyle essentials like diet, exercise, and smoking cessation, the future of prevention will clearly include combination therapies that target inflammation and Lp(a) in addition to cholesterol.” concluded Dr. Ridker.