A blood test to predict CVD in women decades before it arrives?

A simple blood test could identify which women are most likely to suffer from cardiovascular disease 30 years later, a study published in the New England Journal of Medicine finds.This could open the door to early interventions, such as lifestyle modification, to reduce the risk of disease decades later.“We can't assure causality, since this isn't a study that was done prospectively,” said cardiac surgeon Dr. Jessica Forcillo, co-founder of the l'Université de Montréal Health Centre’s Cardio F, which focuses on cardiovascular disease in women.“But we can see that there is an association, so it can give us clues as to which woman would be at greater risk of developing the disease in the future. It’s additional information that helps us better screen for and prevent disease.”Researchers at the U.S. National Institutes of Health (NIH) measured two types of fat in the blood, as well as C-reactive protein, a marker of inflammation.The 28,000 women studied were all from the healthcare sector and had been participating in the huge American Women’s Health Study since 1992 or 1995. During a 30-year followup, 3,662 of them suffered a myocardial infarction, stroke or cardiovascular death. Others required surgery to restore normal circulation.NIH researchers found that women with the highest levels of LDL cholesterol had a 36% higher risk of heart disease than women with the lowest levels.The risk of heart disease was 33% and 70% higher in women with, respectively, the highest levels of lipoprotein(a) and C-reactive protein, again compared to women with the lowest levels.When these three measures were combined, the risk of stroke was 1.5 times greater and that of coronary heart disease three times greater in participants with the highest levels.“Each biomarker contributed independently to the overall risk,” wrote the study authors. “The greatest dispersion of risk was obtained in models that incorporated all three biomarkers.”Although the study only involved women, the researchers believe that the results would be very similar in men.In view of these findings, the study’s authors reiterate the usual advice for promoting coronary health: regular physical activity, a heart-healthy diet, quality sleep, adequate stress management, and of course, avoiding (or giving up) smoking.The earlier in life these measures are adopted, they point out, the greater their combined effect may be decades later. This is even more relevant for women most likely to suffer from cardiovascular disease.“We’re definitely moving towards more individualized medicine,” said Dr. Forcillo. “Every patient has his or her own risk factors. If we test biomarkers, it can give us additional information to say that one woman might be more at risk than another, and then focus followup or the effect of treatment earlier in those women.”

A blood test to predict CVD in women decades before it arrives?

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