A new approach to a routine blood test could predict a person’s 30-year risk of heart disease, research published Saturday in the New England Journal of Medicine found.
Doctors have long assessed their patients’ risk for cardiovascular disease by using a blood test to look at cholesterol levels, focusing particularly on LDL or “bad” cholesterol. But limiting blood testing to just cholesterol misses important — and usually silent — risk factors, experts say.
“We have other biomarkers that tell us about other kinds of biological problems our patients who are destined to have cardiovascular disease are likely to have,” said lead study author Dr. Paul Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital in Boston.
Ridker and his team found that in addition to LDL cholesterol, two other markers — a type of fat in the blood called lipoprotein (a), or Lp(a), and an indicator of inflammation — are important predictors of a person’s risk of heart attack, stroke and coronary heart disease.
The findings were also presented Saturday at the European Society of Cardiology Congress 2024 in London.
In the study, the researchers analyzed data from nearly 30,000 U.S. women who were part of the Women’s Health Study. On average, the women were 55 years old when they enrolled in the years 1992 through 1995. About 13% — roughly 3,600 participants — had either a heart attack or stroke, had surgery to fix a narrowed or blocked artery, or died from heart disease over the 30-year follow-up period.
Though the research was done in women, Ridker said the findings would likely also apply to men.
Still, the focus on women was on purpose, he said. “This is a largely preventable disease, but women tend to be under treated and underdiagnosed.”
All of the women had blood tests done at the beginning of the study to measure their LDL cholesterol, Lp(a) and C-reactive protein levels, a marker of inflammation in the body.
These measurements, individually as well as together, appeared to predict a woman’s heart health over the next three decades, the study found.
Women with the highest levels of LDL cholesterol had a 36% higher risk for heart disease compared with those with the lowest levels. The highest levels of Lp(a) indicated a 33% elevated risk, and those with the highest levels of CRP were 70% more at risk for heart disease.
When the three were looked at together, women who had the highest levels were 1.5 times more likely to have a stroke and over three times more likely to develop coronary heart disease over the next 30 years compared with women with the lowest levels.
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