Researchers have suggested that the evaluation of women's heart disease risks and the initiation of preventive medications should begin in their 30s, rather than post-menopause as currently practiced, according to a study published on Saturday.
The findings were presented at the European Society of Cardiology annual meeting in London. The study demonstrated for the first time that straightforward blood tests can estimate a woman's risk of cardiovascular disease over the next 30 years.
"This is beneficial for patients primarily, but it also provides crucial information for manufacturers of cholesterol-lowering drugs, anti-inflammatory drugs, and lipoprotein(a) lowering drugs—the therapeutic implications are extensive," stated Dr. Paul Ridker of Brigham and Women's Hospital in Boston, the study's lead author.
Current guidelines advise physicians to generally consider preventive therapies for women only in their 60s and 70s. However, these new data clearly indicate that the guidelines need updating, according to Ridker. "We must move beyond discussions of 5 or 10 year risk."
The long-term Women's Health Initiative study, which included 27,939 participants, conducted blood tests between 1992 and 1995 for low-density lipoprotein cholesterol (LDL-C), high-sensitivity C-reactive protein (hsCRP), and lipoprotein(a).
Compared to women with the lowest levels of these markers, those with the highest levels showed significantly higher risks for major cardiovascular events over the next 30 years. Women with all three markers in the highest range were notably more likely to experience major cardiovascular events or strokes.
"The three biomarkers are fully independent and address different biological issues each woman faces," Ridker explained. "The treatments we might employ in response to elevated biomarkers are distinctly different, allowing physicians to specifically target the individual's biological issue."
While drugs that lower LDL-C and hsCRP are readily available, drugs that reduce lipoprotein(a) levels are still in development. Lifestyle changes such as exercise and smoking cessation can also be beneficial.
The study primarily involved white American women, but the findings are expected to have a more significant impact on Black and Hispanic women, who often have higher rates of undetected and untreated inflammation, according to Ridker. "This is a global issue," he added, advocating for universal screening for hsCRP and lipoprotein(a).
