Heart disease is often not the first concern that comes to mind when discussing women’s health. However, recent research suggests that it has become the leading cause of death among women, warranting greater attention. A groundbreaking study presented at the European Society of Cardiology (ESC) Congress in London on August 31 revealed that measuring three biomarkers in the blood during middle age could potentially predict the risk of developing heart disease in women up to 30 years in advance.
The study, published in the New England Journal of Medicine during the ESC meeting, focused on high-sensitivity C-reactive protein (CRP), LDL cholesterol, and lipoprotein(a) levels in the blood. These markers, when measured in middle age, can provide a significant heads-up for women about their heart disease risk.
Researchers described the findings as staggering, as the process of developing coronary artery disease in women begins much earlier in life. By measuring these common indicators, it might be possible to alter the outcome of heart disease risk prevention.
Previous studies have shown that approximately 80% of women aged 40 to 60 have at least one risk factor for coronary artery disease, but only about half of them consider heart disease to be their greatest health risk. Experts suggest that better assessment of risks early in life could help women take critical steps to improve their health before it’s too late.
The study, which followed 40,000 women with an average age of 55 for 30 years, included some participants as young as 40. The research found that these three biomarkers were each associated with an increased risk of cardiovascular disease, with inflammation being the strongest driver.
Women with the highest levels of high-sensitivity CRP, LDL cholesterol, and lipoprotein(a) were 2.6 times more likely to experience a major cardiovascular event and 3.7 times more likely to have a stroke in the next three decades.
Paul Ridker, the lead author of the study and the director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital in the United States, said, The combination of these three tests can predict the cardiovascular risk of seemingly healthy women 30 years before a major event like a heart attack or stroke, which is astonishing in terms of primary prevention. In fact, the process that leads to atherosclerotic disease in these young women begins early in life.
He added that according to current clinical guidelines, women generally do not need to consider preventive treatment for heart disease until they are in their 60s or even 70s. This latest research could potentially lead to changes in these guidelines.
The researchers analyzed that the three indicators affect cardiovascular risk in different ways. LDL cholesterol leads to fatty buildup in the arteries and has long been a classic indicator of heart disease risk. High-sensitivity CRP is a newer indicator, representing the immune system’s response to cholesterol and a measure of latent inflammation in the blood vessels, which is not noticeable. When cholesterol starts to accumulate in the arteries, it forms crystals. The immune system views these crystals as foreign substances and begins to produce a response to clear them, resulting in the production of high-sensitivity CRP.
Lipoprotein(a) is a lipid that can accumulate in blood vessels and form arterial blockages, similar to LDL cholesterol. The risk of high lipoprotein(a) levels is largely genetic. About one-fifth of the global population has high lipoprotein(a) levels but may not be aware of it because they have no symptoms. Some individuals lead healthy lifestyles with normal cholesterol levels but still develop major artery blockages due to elevated lipoprotein(a).
The study also suggests that there is a need for more drugs that can reduce these risk factors early on. Currently, there are medications that can lower LDL cholesterol and help control inflammation, including low-dose colchicine, a drug traditionally used to treat gout. However, there are no drugs specifically approved for lowering lipoprotein(a) levels.
First财经 has learned that pharmaceutical giants, including Novartis, Amgen, and Lilly, are developing drugs to lower lipoprotein(a) levels.
Professor Ge Junbo, an academician of the Chinese Academy of Sciences and the director of the Department of Cardiology at Zhongshan Hospital Affiliated with Fudan University, who is attending the ESC Congress in London, told First财经 that the focus on lipoprotein(a) has been increasing in recent years, and clinical research on related drugs is ongoing in China.
S assessing the risk of heart disease in women has always been challenging
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