Cardiovascular disease is the leading cause of death in women around the globe, while stroke is the third most common.
Cardiovascular disease can sometimes be misdiagnosed in women because their symptoms can be different from those experienced by men, or they may have no symptoms. For example, women are more likely to have a “silent” heart attack than men where there are no obvious symptoms. Younger women typically are concerned about other medical issues such as risks for breast cancer, but heart attack and stroke are major issues for women, as for men, and we need to intervene and start prevention much earlier.
Ridker is the lead author of a new study recently published in the New England Journal of Medicine that that found measuring three different biological blood biomarkers can better predict a woman’s risk of having a major cardiovascular event, such as a heart attack or stroke, over the next 30 years compared to measuring only one biomarker.
For this study, researchers analyzed data from the Women’s Health Study (WHS), funded by the National Institutes of Health (NIH). Since 1993, the study has followed female health professionals ages 45 years and older.
The primary endpoint of the Women’s Health Study was a participant having their first major cardiovascular event, such as a heart attack, stroke, or death from heart-related issues.
All study participants had their blood samples tested for certain biomarkers, including high-sensitivity C-reactive protein (hsCRP), low density lipoprotein cholesterol (LDL-C) — also known as “bad cholesterol” — and lipoprotein(a), or Lp(a), for short.
“The three each represent modifiable and different biologic processes, each of which can be responsible for developing heart disease, The era of ‘one size fits all’ is over and we need to move forward to [address] the specific unique biologic issues each of our patients suffers from. But physicians do not treat with they do not measure, so each of these needs to be evaluated.
All are simple, widely available, inexpensive blood tests. Each biomarker adds to the others — if a woman is unlucky enough to have all three elevated, risks are substantially high. But if we catch this early in life, we can institute preventive therapies now instead of waiting until she is in her late 60’s or 70’s which is how things are done now.
We should be screening in our 30’s and 40’s to give ample time to institute preventive therapies to include dietary discretion, regular exercise, smoking cessation, and where needed drug therapy. Hey are looking at testing people more broadly for lipoprotein [a], which is a new risk factor that we’ve been looking at quite regularly in patients now.
Not only is it considered to be a risk factor for coronary artery disease, but it’s a risk factor for certain valvular heart disease, and it is a test that is very elucidating for people that are at risk for any sort of cardiovascular condition. So to fold that into a woman’s arsenal for preventative testing, I think is extremely important.
