A recent study presented at the European Society of Cardiology annual meeting in London highlights a shift in how women’s cardiovascular risks should be evaluated and managed. The study suggests that blood tests conducted in a woman’s 30s can predict her cardiovascular risk over the next 30 years, challenging the current practice of initiating preventive measures in the 60s or 70s.
Dr. Paul Ridker from Brigham and Women’s Hospital in Boston, who led the study, emphasized that this new approach has significant implications for cardiovascular disease prevention and treatment. “The implications for therapy are broad,” Ridker noted, as this approach could influence the use of cholesterol-lowering drugs, anti-inflammatory medications, and emerging treatments for specific lipid abnormalities.
Current guidelines typically recommend that preventive therapies for cardiovascular disease, such as statins, be considered only when women reach their 60s or 70s. However, the new data suggest that evaluating cardiovascular risks earlier could lead to better long-term outcomes. Ridker argued that these findings necessitate a revision of existing guidelines to account for longer-term risk assessments rather than focusing on shorter time frames.
The study analyzed data from 27,939 participants in the Women’s Health Initiative, who underwent blood tests between 1992 and 1995. The tests measured levels of low-density lipoprotein cholesterol (LDL-C, or “bad cholesterol”), high-sensitivity C-reactive protein (hsCRP), and lipoprotein(a). These markers are associated with cardiovascular risk and inflammation.
Key findings include:
- Women with the highest levels of LDL-C had a 36% higher risk of major cardiovascular events over the next 30 years compared to those with the lowest levels.
- Women with the highest levels of hsCRP had a 70% higher risk of such events.
- Women with the highest levels of lipoprotein(a) had a 33% higher risk.
Those with elevated levels of all three markers were found to be 2.6 times more likely to experience a major cardiovascular event and 3.7 times more likely to suffer a stroke over the next three decades.
Dr. Ridker highlighted that these biomarkers provide independent and complementary information about different biological issues each woman faces. This allows for a more personalized approach to treatment, targeting specific issues identified by the biomarkers.
Current treatments available include statins for lowering LDL-C, and various medications for reducing hsCRP levels. However, therapies targeting lipoprotein(a) are still under development by companies such as Novartis, Amgen, Eli Lilly, and Silence Therapeutics.
Lifestyle changes, such as increased physical activity and smoking cessation, can also help manage these risks.
Although most participants in the study were white Americans, Dr. Ridker suggested that the findings could be particularly impactful for Black and Hispanic women, who may experience higher rates of undetected and untreated inflammation. He called for universal screening for hsCRP and lipoprotein(a), similar to the universal screening already in place for cholesterol, to address this global health issue effectively.
Overall, the study underscores the need for a proactive approach to cardiovascular risk assessment and prevention, potentially reshaping how and when preventive treatments are recommended for women.
