A simple blood test could identify women most likely to suffer from cardiovascular disease thirty years later, according to a study published in the prestigious New England Journal of Medicine.
This could open the door to early interventions, such as lifestyle changes, to reduce the risk of disease decades later. “We can’t guarantee causality since this is not a study that was done prospectively,” said cardiac surgeon Jessica Forcillo, who is the co-founder of the CardioF Expertise Center at the CHUM. “But we can see that there is an association, so it can give us clues about which women (…) would be at greater risk of developing the disease in the future. This is additional information that helps us better screen and prevent diseases.” Researchers from the U.S. National Institutes of Health (NIH) measured two types of fat in the blood as well as C-reactive protein, a marker of inflammation.
The approximately 28,000 women studied were all from the health care sector and had been participating in the massive American Women’s Health Study since 1992 or 1995. During a thirty-year follow-up, 3,662 of them suffered a heart attack, stroke or cardiovascular death. Others required surgery to restore normal circulation. The NIH researchers found that women with the highest levels of LDL cholesterol had a 36% higher risk of heart disease than women with the lowest levels. The risk of heart disease was 33% and 70% higher in women with the highest levels of lipoprotein(a) and C-reactive protein, respectively, compared with women with the lowest levels.
When all three measures were combined, the risk of stroke was 1.5 times greater and the risk of coronary heart disease was three times greater in participants with the highest levels. “Each biomarker contributed independently to the overall risk,” the study authors write. “The greatest dispersion of risk was obtained in models that incorporated all three biomarkers.” And although the study only included women, the researchers believe the results would be very similar in men. Given these results, the study authors reiterate the usual advice for promoting coronary health: regular physical activity, a heart-healthy diet, quality sleep, adequate stress management, and of course, avoiding (or quitting) smoking.
The earlier these measures are adopted in life, they point out, the greater their combined effect can be decades later. This is even more relevant for women who are most likely to suffer from cardiovascular disease. “We are definitely moving towards a more individualized form of medicine,” said Dr. Forcillo. “Each patient has their own risk factors. If we test biomarkers, it can give us additional information to say that one woman would be more at risk than another, and then to focus monitoring or the effect of a treatment earlier on these women.”
Caption and photo credit: When all three measures were combined, the risk of stroke was 1.5 times greater and the risk of coronary heart disease was three times greater in participants with the highest levels. (Courtesy: ICM) Jean-Benoit Legault
