Evaluating Heart Disease Risk in Women: A Need for Earlier Prevention

Women should start assessing their heart disease risks in their 30s, not just after menopause, says new research. This call to action comes from researchers who published a study presented at the European Society of Cardiology annual meeting in London. The new research reveals, for the first time, that simple blood tests can predict a woman’s risk of cardiovascular disease over the next 30 years.

Early Risk Assessment is Crucial

The study’s findings highlight the importance of early risk evaluation. Currently, guidelines suggest that women should generally not be considered for preventive therapies until their 60s or 70s. However, Dr. Paul Ridker of Brigham and Women’s Hospital in Boston, the study leader, argues that these guidelines need to change. “We must move beyond discussions of 5 or 10-year risk,” Ridker said, emphasizing that women need to be evaluated much earlier.

Key Blood Markers in Heart Disease

The research involved 27,939 participants from the long-term Women’s Health Initiative study, who had blood tests between 1992 and 1995. These tests measured low-density lipoprotein cholesterol (LDL-C or “bad cholesterol”), high-sensitivity C-reactive protein (hsCRP), and lipoprotein(a). The study showed that women with the highest levels of these markers had significantly higher risks of major cardiovascular events over the next 30 years. For instance, women with the highest LDL-C levels had a 36% higher risk, those with high hsCRP levels had a 70% higher risk, and those with high lipoprotein(a) levels faced a 33% higher risk.

Women with elevated levels of all three markers were 2.6 times more likely to experience a major cardiovascular event and 3.7 times more likely to suffer a stroke within the next three decades.

Implications for Treatment and Global Health

The study’s findings carry broad implications for both patients and the pharmaceutical industry. “This is good for patients first and foremost, but it is also important information for manufacturers of cholesterol-lowering drugs, anti-inflammatory drugs, and lipoprotein(a)-lowering drugs,” Ridker stated. Drugs targeting LDL-C and hsCRP, such as statins, are already widely available, but treatments for reducing lipoprotein(a) levels are still under development by companies like Novartis, Amgen, Eli Lilly, and Silence Therapeutics.

Lifestyle changes, such as regular exercise and quitting smoking, can also play a role in reducing these risks. Although the majority of study participants were white Americans, Ridker noted that the findings could have even more significant implications for Black and Hispanic women, who face a higher prevalence of undetected and untreated inflammation. He called for universal screening for hsCRP and lipoprotein(a), similar to the existing universal screening for cholesterol.

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