Measuring inflammation and certain blood fats in midlife may help detect and treat heart disease earlier. Research funded by the National Institutes of Health found that checking C-reactive protein (CRP), a marker of inflammation and two types of fat in the blood, can predict a woman’s risk of heart disease decades later.
The study followed nearly 28,000 women for 30 years and found that high levels of CRP, LDL cholesterol, and lipoprotein(a) were linked to heart attacks, strokes, and other cardiovascular issues. The findings were shared at the European Society of Cardiology Congress 2024 and published in the New England Journal of Medicine.
Participants were divided into five groups based on their levels of three markers: LDL cholesterol, Lp(a), and CRP. Women with the highest LDL cholesterol had a 36% higher risk of heart disease, those with the highest Lp(a) had a 33% higher risk, and those with the highest CRP had a 70% higher risk.
When all three markers were high, the risk of stroke was over 1.5 times higher, and the risk of coronary heart disease was more than three times higher than for those with the lowest levels.
Researchers believe similar results would be seen in men. Dr. Ahmed A.K. Hasan noted that high inflammation and lipid levels increase heart disease risk, emphasizing that lower levels are generally better.
Immune cells that help heal wounds can also detect extra cholesterol and plaque buildup, sending out inflammatory signals. This can create a highly inflammatory environment, causing plaque to grow or rupture, leading to heart problems.
To maintain good heart health, researchers recommend primary prevention, like regular exercise, a heart-healthy diet, managing stress, and avoiding or quitting smoking. Medications to lower cholesterol and inflammation might be needed for those at higher risk.
Taking steps early in life can lead to better heart health in the future. LDL cholesterol is commonly treated with statins, but screening for Lp(a) and CRP may vary.
Some countries recommend Lp(a) screening since high levels often come from inherited risks. Doctors may test those with heart disease or family history in places without universal Lp(a) screening, like the U.S. Some treatments for high Lp(a) levels exist, and new ones are being researched.
CRP testing varies and often depends on a person’s risk or the doctor’s judgment. In 2023, the FDA approved colchicine, an anti-inflammatory drug, for reducing heart disease risk in people with atherosclerosis. Other anti-inflammatory treatments are also being studied.
Journal reference:
- Paul M. Ridker, M. Vinayaga Moorthy, et al., Inflammation, Cholesterol, Lipoprotein(a), and 30-Year Cardiovascular Outcomes in Women. The New England Journal of Medicine. DOI: 10.1056/NEJMoa2405182.