The risk of heart attack and stroke can be detected 30 years in advance. A simple test is enough

The study involved almost 40,000 women who were followed for 30 years. The observations began in the 1990s, and the average age of the women studied was 55. The results were first published simultaneously during the recently concluded congress of the European Society of Cardiology (ESC) in London and in the New England Journal of Medicine.

They show that up to 30 years in advance, it is possible to predict which women are at greater risk of heart attack and stroke. This allows for timely preventive and therapeutic action. Especially since cardiovascular diseases are still the leading cause of death in women.

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The researchers say that what is most surprising is that simple blood tests are enough to check three long-known risk factors for cardiovascular disease: measurement of the so-called bad LDL cholesterol, C-reactive protein (CRP) and lipoprotein LP. “These tests are widely available,” noted the study's lead author, Prof. Paul Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital. They are also cheap, both in USAas well as in Poland.

Combining these three tests allows for better prognosis of cardiovascular diseases in women. LDL is one of the cholesterol fractions in the blood characterized by low density, hence its name (low density lipoprotein, LDL). C-reactive protein (CRP) is classified as an acute phase protein, produced in larger quantities in response to an ongoing inflammatory process (for example, as a result of the deposition of atherosclerotic plaques in the inner walls of arteries).

In turn, LP lipoprotein is structurally similar to LDL, also has low density and has strong properties that promote vascular atherosclerosis. Its elevated level in the blood is a separate risk factor for cardiovascular diseases, largely genetically determined. It occurs in every fifth person, usually unaware of it.

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According to research sponsored by the US National Institute of Health, of these three substances, C-reactive protein poses the greatest risk. An increase in CRP in the blood above 5.18 milligrams per liter by 70 percent increases the risk of so-called cardiac events. LDL above 151 milligrams per deciliter increases it by 36 percent, and an increase in LP above 44 milligrams per deciliter – by 33 percent.

However, women who have all three factors are at much greater risk of heart attack and stroke. These women have a three times greater risk of heart attack and a four times greater risk of stroke, compared to those who have none of these factors.

Prof. Paul Ridker believes that it is crucial to detect women with three risk factors in order to treat them appropriately in time. “This is the main conclusion from our study,” he emphasizes. He also points out that statins, cholesterol-lowering drugs, are often not used in women until they are 65, while in the case of men they are prescribed to people in their fifties.

According to the specialist, detecting LDL, CRP and LP in the blood should be a routine test in primary care for women. However, this is often not the case. Such a test is all the more important because it is more difficult to assess the risk of cardiovascular disease in women. It usually develops in them 10 years later compared to men.