Single Blood Test Predicts 30-Year Cardiovascular Disease Risks for Women

Recent research has shed light on how elevated inflammation levels can interact with lipids to exacerbate the risk of cardiovascular disease. Immune cells, essential for healing wounds or fighting infections, can also react to excess cholesterol in cells or respond to plaque buildup by releasing inflammatory signals. This response can lead to a hyperinflammatory state that fosters plaque growth, which might enlarge or rupture, potentially leading to cardiovascular incidents. Typically, healthcare providers measure low-density lipoprotein (LDL) cholesterol, and some countries also screen for lipoprotein(a) or Lp(a)—a lipid component related to LDL known to be influenced by genetic factors. The testing for C-reactive protein (CRP), an inflammation marker, varies, with screening often based on individual risk assessments or at the provider's discretion. Now, new research suggests that analyzing these two types of fat in the bloodstream alongside CRP can help predict a woman’s risk of developing cardiovascular disease decades in advance.

In the research supported by the National Institutes of Health (NIH, Bethesda, MD, USA), investigators at Brigham and Women’s Hospital (Boston, MA, USA) analyzed blood samples and medical information of 27,939 healthcare providers in the U.S. participating in the Women’s Health Study. These women, who were an average age of 55 at the start of the study from 1992-1995, were monitored over 30 years. During this time, 3,662 participants experienced a cardiovascular event such as a heart attack, stroke, circulatory system surgery, or cardiovascular-related death. The study examined how high-sensitivity CRP, LDL cholesterol, and Lp(a) levels individually and collectively predicted these incidents. Participants were categorized into five groups based on their levels of each marker.

The findings revealed that women in the highest LDL cholesterol group had a 36% higher risk of heart disease compared to those in the lowest group. Those with the highest Lp(a) levels faced a 33% increased risk, and those with elevated CRP levels saw a 70% increased risk. Considering all three indicators—LDL cholesterol, Lp(a), and CRP—simultaneously, those with the highest levels had over a 1.5-times higher risk for stroke and more than three times higher risk for coronary heart disease compared to those with the lowest levels. These significant findings were presented as late-breaking research at the European Society of Cardiology Congress 2024 and published in the New England Journal of Medicine. The researchers also noted that while this study focused on women, similar outcomes would likely be observed in men.

“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.

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