Recent research, supported by the National Institutes of Health (NIH), has demonstrated that a blood test measuring inflammation and lipid levels can predict a woman’s risk for cardiovascular disease decades in advance. This study, presented at the European Society of Cardiology Congress 2024 and published in the New England Journal of Medicine, offers new insights into early detection and preventive strategies for heart disease.
The study analyzed data from 27,939 U.S. health care providers who were part of the Women’s Health Study, which began between 1992 and 1995. Participants, who started the study at an average age of 55, were tracked for a period of 30 years. Over this extensive follow-up, 3,662 participants experienced significant cardiovascular events, including heart attacks, strokes, surgeries to restore circulation, or deaths related to cardiovascular disease.
Researchers assessed blood samples from these participants for three key biomarkers: high-sensitivity C-reactive protein (CRP), low-density lipoprotein (LDL) cholesterol, and lipoprotein(a) [Lp(a)], a type of lipid that is partially composed of LDL cholesterol. Participants were categorized into five groups based on their levels of these markers to determine their associated cardiovascular risk.
The findings revealed significant correlations between elevated levels of these biomarkers and increased cardiovascular risk. Women with the highest levels of LDL cholesterol had a 36% increased risk of developing heart disease compared to those with the lowest levels. Similarly, those with elevated Lp(a) levels faced a 33% higher risk, while those with high CRP levels had a striking 70% increased risk of cardiovascular events.
When considering all three biomarkers together—LDL cholesterol, Lp(a), and CRP—the study found that women with the highest combined levels had more than a 1.5-fold increased risk for stroke and over a three-fold increased risk for coronary heart disease compared to those with the lowest levels. This suggests that evaluating these markers collectively provides a more comprehensive risk assessment than measuring each one in isolation.
Dr. Ahmed A.K. Hasan, M.D., Ph.D., a medical officer at NIH’s National Heart, Lung, and Blood Institute (NHLBI), commented on the implications of these findings: “Our improved understanding of how inflammation and lipid levels interact to heighten cardiovascular risks highlights the necessity of maintaining lower levels of these markers. This insight is crucial for advancing early detection and preventive measures.”
Inflammatory responses play a critical role in cardiovascular disease. Immune cells, which are essential for repairing tissue damage and fighting infections, also respond to excess cholesterol by triggering inflammation. This inflammatory process can contribute to plaque formation in blood vessels, which may become unstable and lead to cardiovascular events.
To support optimal cardiovascular health, the study underscores the importance of primary prevention strategies. These include engaging in regular physical activity, following a heart-healthy diet, managing stress effectively, and avoiding or quitting smoking. For individuals identified as high-risk based on these biomarkers, additional preventive measures might involve medications aimed at lowering cholesterol levels and/or reducing inflammation.
Currently, LDL cholesterol is routinely measured and managed with therapies such as statins. However, the approach to screening for Lp(a) and CRP varies. In some countries, Lp(a) screening is recommended due to its hereditary nature, while in the United States, such tests are generally performed for those with a history of heart disease or a family history of cardiovascular issues. New treatments and personalized approaches for managing elevated Lp(a) levels are under investigation.
CRP screening practices are less uniform and often depend on individual risk factors or the discretion of healthcare providers. Recent advancements include the FDA’s approval of colchicine, an anti-inflammatory medication previously used for gout, to help reduce cardiovascular disease risks. Ongoing research is exploring additional anti-inflammatory therapies and strategies to improve cardiovascular health management and potentially offer more tailored treatments.
This research highlights the potential of using a simple blood test to predict long-term cardiovascular risks in women, emphasizing the importance of early intervention and preventive strategies to reduce the incidence of heart disease.
