Women at risk of heart attack and stroke may be overlooked and undertreated
In a groundbreaking development, a large-scale study has underscored the significance of inflammation as a potential risk factor for heart disease in women. The study, which focused on high-sensitivity C-reactive protein (hsCRP) as a predictor of cardiovascular events in otherwise healthy women, was conducted over 30 years and analysed data from over 12,000 participants.
The study, led by Dr. Paul Ridker, found that out of nearly 28,000 women with no standard modifiable risk factors for heart disease, 12,530 experienced 973 cardiovascular events. Notably, higher levels of hsCRP were found among women who experienced these events.
Dr. Ridker, the study's lead author, emphasised the importance of hsCRP testing, stating that if it isn't measured, these women won't get the lifesaving treatment they need. He further suggested that inflammation should be included in heart disease screenings, as high inflammation can be treated with statins, but these women would not qualify for a statin prescription with a healthy cholesterol reading.
The study supports the notion that women with elevated hsCRP levels but no other classic cardiovascular risk factors may benefit from primary prevention with statin therapy to reduce the rates of severe heart attacks and strokes. This approach is in line with the findings of a previous clinical trial, which showed that women who do not have the standard modifiable risk factors could benefit from treatment with statins, with a 38% reduction in serious cardiovascular events such as stroke and heart attack if they received statin therapy.
Dr. Tania Ruiz, a medical professional, called the study "very exciting" and the first large-scale study of hsCRP as a predictor of cardiovascular events in otherwise healthy women. She also noted that women with autoimmune diseases such as lupus may be more likely to have a high hsCRP score, but without testing, there's no way to know.
The analysis of the Women's Health Study data revealed that inflammation, like high LDL cholesterol, is a significant risk factor for heart disease in women. Dr. Ruiz highlighted the role of inflammation in the formation of plaques and plaque vulnerability in recent years.
The study used data from the Women's Health Study, launched by the National Heart, Lung, and Blood Institute in the early 1990s. Dr. Anais Hausvater, a cardiologist, called the study "potentially practice changing." She further recommended that screening for hsCRP should be routine for all women.
It's important to note that high levels of inflammation do not have outward signs and are not a standard part of screening in the United States. However, the study's findings underscore the need for increased awareness and routine testing of hsCRP to potentially prevent heart attacks and strokes in women who may be at risk due to elevated levels of inflammation.
In Europe, it's already the standard of care to measure hsCRP, and it's an inexpensive blood test that can measure inflammation. As more research emerges, it's hoped that the United States will follow suit and make hsCRP testing a standard part of heart disease screenings for women.
