Simple blood test could predict a person’s heart disease risk 30 years out, study finds

A novel method to approach a common screening exam could forecast an individual’s heart disease risk over the next three decades, according to research revealed Saturday in the New England Journal of Medicine. 
 
Physicians have traditionally evaluated patient’s risk of developing CVD with a blood test that examines cholesterol levels, therefore professionals paid close attention to LDL or ‘’bad’’ cholesterol. However, confining the blood testing only to cholesterol ignores other potent – and mostly asymptomatic complications, according to specialists. 
 
“We have other biomarkers that can inform us on other sorts of biologic issues our patients who are fated to have cardiovascular disease are prone to have,” said the study senior author, Dr. Paul Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital, in Boston. 

Ridker and his team identified two other traits associated with a person’s risk of having a heart attack, stroke or coronary heart disease, namely lipoprotein (a), or Lp(a) — a form of blood fat – and inflammation. 
 
The details were also shared on Saturday at congress of the European Society of Cardiology Congress in London 2024. 
 
To extract the necessary information for the research, the authors included almost 30000 women from the Women’s Health Study in USA. In total, these women enrolled in the fourth year of high school in the academic years 1992/3 and 1994/5: the average age of the women on entry was 55 years. Of these people, nearly half or 5,200 participants developed other cardiovascular risk factors such as hypertension, high cholesterol, or high blood sugar, while 3,600 of them had a heart attack or stroke, had a coronary artery bypass or angioplasty done, or died from heart disease in the course of the 30-year follow-up. 
 
Despite the fact that the study was conducted for women only, Ridker said that similar results could be expected in men as well. 
 
However, keeping the accent on women was not a mistake, he said. For one, it must be noted that breast cancer is in many ways a very preventable disease, though women are often not treated appropriately and quite frequently the disease is not even discovered or diagnosed in the early stages. 
 
At the point of recruitment, all the women underwent fasting blood sample collection to determine their LDL cholesterol, Lp(a) and C-reactive protein. 
 
These measurements, whether separately or combined, seemed to indicate that a woman’s heart health in thirty years, the same study also showed. 
 
The study showed that those women who had high LDL cholesterol levels had 36% increased heart disease risk compared to woman with the lowest levels of LDL cholesterol. The people with hi Lp(a) status showed a risk 33% more, while people with high CRP status were 70% at a risk of developing a heart disease. 
 
Combined, the three was giving the women with the highest levels were 1. Men using such products are five times more likely to have a stroke and over three times as likely to have coronary heart disease over the next three decades than that of women with the least consumption. 
 
Each of the markers has been associated in prior research with an increased susceptibility to heart disease but, “all three are different biological markers,” Ridker explained. 
 
Intervening early 
 
Such risk factors associated with heart diseases are obesity, diabetes, hypertension and hyperlipidemia. Two other analytes that can indicate hidden factors include Lp(a) and CRP. 
 
“You can be perfectly healthy, you can be a non-smoker, you can have elevated cholesterol yet, all the knowledge that we had prior to this article could not protect you,” said Dr. Rachel Bond. 
 
Lp(a) testing should be done at least once in a lifetime, according to Bond. Those who have high levels at one time or the other will for life have high levels of these chemicals. There is one caveat: Bond said women who have passed their menopausal stage can get high Lp(a) and may require to go for the test again at that time. 
 
On the contrary, an LDL cholesterol and CRP levels are changeable in the course of a man’s life. Ridker emphasizes that doctors should perform the three-part blood test in patients who are 30- or 40-something years old to look for the potentially missed risks, so that, the window of change is not missed. 
 
While getting exercise, eating well and not smoking is a good idea, expectant patients with high levels of Lp(a), LDL and CRP will need medication, according to Dr. Steven Nissen, chief academic officer of the Heart , Vascular and Thoracic Institute at the Cleveland Clinic, who did not participate in the study. 
 
“We cannot wait for the lifestyle changes to take care of the job for most people,” Nissen added. 
 
There were few limitations to the study that could be adopted in future research, for instance, the samples did not comprise people from different racial or ethnic backgrounds, despite the fact that they are identified markers of risk for heart diseases. About one-fourth of the participants identified themselves as African- American; the remainder were white, 94 percent in all. 
 
Nissen also stated that the study ceased to monitor the Lp(a) levels once these reached some predefined limit. 
 
“Even the highest levels of lipoprotein (a) in this study did not go as high as the acceptable levels for treatment,” he said. “It tends to underestimate the lipoprotein (a) risk. ” 
 
A Johns Hopkins Bloomberg School of Public Health epidemologist specializes in cardiology Dr. Kunihiro Matsushita said that while inflammation is of vital importance what is left is still uncertain: “That doesn’t mean CRP is the best marker for predicting cardiovascular disease risk. ” 
 
“It is nice to use three biomarkers, but a direction on which biomarkers these are can be looked at further,” said Matsushita who was not involved in the new study. 
 
He also noted that getting inflammation, LDL and Lp(a) checked is especially essential for folks not considered to be at high risk of heart disease, like women, young people, and people of East Asian descent. 
 
Ridker agreed. 
 
This, he said, will help address the issue whereby, physicians do not treat things, they do not measure.