Predicting a woman’s future heart disease risk could be as simple as administering a single blood test to screen for three risk factors. That’s according to research published in The New England Journal of Medicine on Saturday — research that was also presented at the European Society of Cardiology (ESC) Congress this weekend. The study, which included nearly 30,000 women averaging 55 years of age, measured two types of fat in the bloodstream along with a certain type of protein with a blood test in 1993, then monitored the participants’ health for a 30-year period, the researchers said.
Dr. Paul Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital in Boston, who is the lead study author, stated, “The strongest predictor of risk was a simple blood measure of inflammation known as high sensitivity C-reactive protein, or hsCRP, followed by cholesterol and lipoprotein(a).” He emphasized the importance of this study in predicting risks not just at five or 10 years, but at 20 and 30 years, providing a roadmap for targeted therapies for individual patients.
C-reactive protein (CRP) is a protein produced by the liver that rises during inflammation in the body, according to Mayo Clinic. High levels of CRP indicate an elevated risk of heart disease. LDL cholesterol, also known as the “bad” cholesterol, can accumulate in the arteries, increasing the chances of heart attack or stroke. Lipoprotein(a), or Lp(a), is a type of LDL cholesterol that can also lead to plaque buildup in the arteries. These three factors were found to be significant indicators of future heart disease risk in the study.
Women with the highest levels of LDL cholesterol had a 36% increased associated risk for heart disease compared to those with the lowest levels, while those with the highest levels of Lp(a) had a 33% greater risk. The study also revealed that women with the highest levels of CRP were at a 70% increased associated risk for heart disease. Women who had high levels of all three measures were 1½ times more likely to experience a stroke and more than three times as likely to develop coronary heart disease.
While most doctors typically measure cholesterol levels, very few measure hsCRP and Lp(a) levels. Dr. Ridker highlighted the importance of measuring all three factors to accurately predict heart disease risks and emphasized the need for a change in current screening guidelines to start prevention efforts earlier in life.
Dr. Marc Siegel, a senior medical analyst for Fox News and clinical professor of medicine at NYU Langone Medical Center, commended the study for its comprehensive approach in using a combination of blood tests to determine cardiac risk. He noted that inflammation, indicated by elevated CRP levels, has been confirmed to increase the risk of heart disease. Siegel predicts that in the future, blood markers like these will be used in combination with artificial intelligence to assess the risk of heart disease and stroke.
Based on these findings, Dr. Ridker recommends that patients request their physicians to specifically measure hsCRP and Lp(a) levels. He emphasized that while initial prevention efforts should focus on lifestyle changes such as a heart-healthy diet, regular exercise, smoking cessation, and stress management, some patients may benefit from drug therapies to reduce inflammation and lower cholesterol levels.
The study acknowledged that the participants were primarily health professionals, which could be a limitation in terms of generalizability. However, Dr. Ridker noted that similar concerns exist for men and minority individuals in other settings, underscoring the importance of early prevention efforts in combating heart disease.
In conclusion, the research funded by the National Institutes of Health (NIH), the National Heart, Lung, and Blood Institute (NHLBI), and the National Cancer Institute (NCI) sheds light on the significance of measuring hsCRP, LDL cholesterol, and Lp(a) levels in predicting heart disease risks up to 30 years in advance. This groundbreaking study provides valuable insights into personalized medicine and preventive strategies that could potentially save lives.