Single Blood Test Predicts Cardiovascular Disease Risks in Women

Research supported by the National Institutes of Health (NIH) has found that measuring two types of fat in the bloodstream along with C-reactive protein (CRP), a marker of inflammation, can predict a woman’s risk for cardiovascular disease decades later. These findings were presented as late-breaking research at the European Society of Cardiology Congress 2024, and published in the New England Journal of Medicine.
 
“We can’t treat what we don’t measure, and we hope these findings move the field closer to identifying even earlier ways to detect and prevent heart disease,” said Paul M. Ridker, M.D., M.P.H., a study author and the director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital, Boston.
 
To support optimal cardiovascular health, the researchers emphasize primary prevention. This includes getting regular physical activity, eating a heart-healthful diet, managing stress, and avoiding tobacco or quitting smoking. 
 
In the study, blood samples and medical information from 27,939 healthcare providers living in the US who participated in the Women’s Health Study were collected. 
 
Women, who started the study between 1992-1995 at an average age of 55, were followed for 30 years. During this period, 3,662 study participants experienced a heart attack, stroke, surgery to restore circulation, or a cardiovascular-related death. 
 
Researchers assessed how high-sensitivity CRP, along with low-density lipoprotein (LDL) cholesterol and lipoprotein(a), or Lp(a), a lipid partly made of LDL, singularly and collectively predicted these events.
 
Researchers found that women with the highest levels of LDL cholesterol had a 36% increased associated risk for heart disease compared to those with the lowest levels. Those with the highest levels of Lp(a) had a 33% increased associated risk, and those with the highest levels of CRP had a 70% increased associated risk.
 
When all three measures were assessed together, participants with the highest levels had more than a 1.5-times increased associated risk for stroke and more than a three-times increased associated risk for coronary heart disease compared to women with the lowest levels.
 
Researchers have found that steps people take earlier in life to support their heart, and vascular health can add up over time and correlate with better health outcomes years later.
 
Immune cells, which help the body repair itself from wounds or infection, can also sense the accumulation of extra cholesterol in cells or become activated in response to the build-up of plaque and send out inflammatory signals. This creates a hyperinflammatory environment.
 
Colchicine, an anti-inflammatory therapy previously used for gout, was approved by the Food and Drug Administration in 2023 to offset risks for cardiovascular disease among people with atherosclerosis. Additional anti-inflammatory therapies and approaches are being studied.
 
LDL cholesterol, which is routinely measured by healthcare providers, can be treated with widely available therapies, such as statins. 
 
Some therapies are available for those with elevated levels of Lp(a) and researchers are testing new approaches to personalize and improve treatment options.