New Delhi: Researchers recommend evaluating women’s heart disease risks and preventive medication needs starting in their 30s instead of waiting until well after menopause, according to a study presented at the European Society of Cardiology annual meeting in London.
The study, which utilised simple blood tests to estimate cardiovascular risk over the next three decades, was conducted by Dr Paul Ridker and his team at Brigham and Women’s Hospital in Boston.
Ridker said the current guidelines suggest that women should generally not be considered for preventive therapies until their 60s and 70s. “These new data clearly demonstrate that our guidelines need to change. We must move beyond discussions of 5 or 10 year risk,” Ridker inisisted.
The long-term study, involving 27,939 participants from the Women’s Health Initiative, included blood tests conducted between 1992 and 1995. These tests measured low-density lipoprotein cholesterol (LDL-C), also known as “bad cholesterol,” high-sensitivity C-reactive protein (hsCRP), an inflammation marker, and lipoprotein(a), a specific type of genetically determined fat.
Results showed that women with the highest levels of these markers had significantly increased risks for major cardiovascular events. Compared to those with the lowest levels, women with elevated LDL-C had a 36 per cent higher risk, those with increased hsCRP had a 70 per cent higher risk, and those with elevated lipoprotein(a) had a 33 per cent higher risk. Women with high levels of all three markers were 2.6 times more likely to experience a major cardiovascular event and 3.7 times more likely to have a stroke over the next 30 years.
On the study which was published in The New England Journal of Medicine, Ridker said, “The three biomarkers are fully independent of each other and tell us about different biologic issues each individual woman faces.”
“The therapies we might use in response to an elevation in each biomarker are markedly different, and physicians can now specifically target the individual person’s biologic problem.”
While LDL-C and hsCRP can be managed with widely available drugs, including statins and certain medications for high blood pressure and heart failure, drugs to lower lipoprotein(a) are still in development. Companies working on these drugs include Novartis, Amgen, Eli Lilly, and London-based Silence Therapeutics.
Lifestyle changes, such as increased exercise and quitting smoking, can also help manage these risks.
Most study participants were white Americans, but the findings are believed to have broader implications. “This is a global problem,” Ridker noted. “We need universal screening for hsCRP … and for lipoprotein(a), just as we already have universal screening for cholesterol.”
Ridker also highlighted the greater impact this could have among Black and Hispanic women, who face higher prevalence rates of undetected and untreated inflammation. “The three biomarkers are fully independent of each other and tell us about different biologic issues each individual woman faces,” Ridker added.
The call for more widespread and early screening marks a crucial step towards better cardiovascular health for women worldwide. “This is good for patients first and foremost, but it is also important information for manufacturers of cholesterol-lowering drugs, anti-inflammatory drugs, and lipoprotein(a)-lowering drugs – the implications for therapy are broad,” Ridker explained.
