New Blood Test Method Could Predict 30-Year Heart Disease Risk, Study Reveals

A groundbreaking study published in the New England Journal of Medicine and presented at the European Society of Cardiology Congress 2024 offers a fresh perspective on assessing long-term heart disease risk.

Traditional methods typically rely on cholesterol levels, particularly LDL or “bad” cholesterol, to gauge cardiovascular health. However, this new research suggests that incorporating additional biomarkers can significantly enhance the accuracy of these predictions.

Dr. Paul Ridker, the study’s lead author and director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital, emphasizes that relying solely on cholesterol levels overlooks crucial risk factors.

“We have other biomarkers that tell us about other kinds of biological problems our patients who are destined to have cardiovascular disease are likely to have,” Ridker explains.

The research identified two additional markers—lipoprotein (a), or Lp(a), and C-reactive protein (CRP)—as significant predictors of heart disease. These markers, along with LDL cholesterol, can provide a more comprehensive risk assessment.

Study Details and Findings

The study analyzed data from nearly 30,000 U.S. women enrolled in the Women’s Health Study between 1992 and 1995. At the study’s start, participants had their LDL cholesterol, Lp(a), and CRP levels measured.

Over the 30-year follow-up period, approximately 3,600 participants experienced serious cardiovascular events, including heart attacks, strokes, or death from heart disease.

Dr. Ridker’s team found that high levels of each marker were individually linked to increased risk. Women with elevated LDL cholesterol had a 36% higher risk of heart disease, while high Lp(a) levels were associated with a 33% increased risk.

Elevated CRP levels indicated a 70% higher risk.

When all three markers were considered together, women with the highest levels were 1.5 times more likely to suffer a stroke and over three times more likely to develop coronary heart disease over 30 years compared to those with the lowest levels.

Implications for Heart Disease Prevention

Traditionally, heart disease risk assessment has focused on well-known factors such as obesity, diabetes, and high blood pressure. The addition of Lp(a) and CRP testing could uncover less obvious risk factors that are not addressed by lifestyle changes alone.

Dr. Rachel Bond, director of women’s heart health at Dignity Health, advocates for one-time Lp(a) testing, noting that high levels, once identified, remain a lifelong risk factor. Post-menopausal women might consider retesting due to potential changes in Lp(a) levels.

Dr. Steven Nissen, chief academic officer of the Heart, Vascular, and Thoracic Institute at the Cleveland Clinic, stresses the importance of early intervention.

“Although exercising, eating well, and not smoking are all crucial, people with elevated levels of Lp(a), LDL, and CRP will likely require medication,” he says. He suggests that the combined use of these biomarkers could lead to earlier and more effective treatment strategies.

Study Limitations and Future Directions

While promising, the study has limitations. The participant pool was predominantly white, which may affect the applicability of the findings to more diverse populations.

Additionally, the study’s methodology included stopping Lp(a) measurement once it reached a certain threshold, potentially underestimating its risk.

Dr. Kunihiro Matsushita from Johns Hopkins Bloomberg School of Public Health highlights that while CRP is an important marker, it might not be the best predictor of cardiovascular risk.

He suggests further research to explore the optimal combination of biomarkers for predicting heart disease.

This new approach to heart disease risk assessment represents a significant shift in cardiovascular health management.

By incorporating multiple biomarkers into routine blood tests, physicians can gain a more accurate and comprehensive understanding of an individual’s long-term risk. As Dr. Ridker aptly notes, “Physicians will not treat things they don’t measure.”

This enhanced diagnostic method could pave the way for more personalized and effective prevention strategies in the fight against cardiovascular disease.