Heart disease is often not the first concern that comes to mind when discussing women’s health. However, recent research has highlighted that it is indeed 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 has revealed that measuring three biomarkers in the blood during middle age could potentially predict the risk of heart disease for women up to 30 years in advance.
The study, which was published in the New England Journal of Medicine during the ESC, focused on high-sensitivity C-reactive protein (CRP), LDL cholesterol, and lipoprotein(a) levels. These biomarkers, when measured in middle age, could provide women with an early indication of their risk of developing heart disease.
Researchers described the findings as stunning, as the process of developing coronary artery disease in women begins much earlier in life than previously thought. By measuring these common indicators, it might change the outcome of preventive interventions for heart disease risk.
Previous research has shown that approximately 80% of women aged 40 to 60 have at least one risk factor for coronary artery disease, yet only about half of them consider heart disease to be their greatest health risk. Experts suggest that better assessment of risk at an earlier stage in life could help women take crucial steps to improve their health, rather than waiting until 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 within the next three decades.
Paul Ridker, the study’s author 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 up to 30 years before a major event like a heart attack or stroke. This has a profound impact on primary prevention. In fact, the process that leads to atherosclerotic disease in these young women begins early in life.
Ridker 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 marker for heart disease risk. High-sensitivity CRP is a newer marker, part of the immune system’s response to cholesterol, and is a way for researchers to measure latent inflammation in the blood vessels, which is not noticeable to individuals. 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, during which high-sensitivity CRP is produced.
Lipoprotein(a) is a lipid that can accumulate in blood vessels and form arterial-blocking plaques, 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 they may not be aware of it because they have no symptoms. Some people lead healthy lifestyles and have normal cholesterol levels but still experience major artery blockages due to elevated lipoprotein(a).
The study also suggests that there is a need for more medications that can reduce these risk factors early on. Currently, there are drugs that can lower LDL cholesterol and help control inflammation, including low-dose colchicine, 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 Eli Lilly, are developing drugs to reduce lipoprotein(a) levels.
Professor Ge Junbo, an academician of the Chinese Academy of Sciences and the director of cardiology at Zhongshan Hospital Affiliated with Fudan University, who is attending the ESC Congress in London, told First财经 that in recent years, there has been increasing attention on lipoprotein(a). Clinical research on related drugs is
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