Fats in blood, with inflammation, could better predict heart disease risk in women, study finds

New Delhi: A blood test measuring two specific fats, along with inflammation, could help predict a woman's risk of developing heart conditions in the next 30 years, according to a study in nearly 28,000 women in the US.

The two fats in one's blood sample that the test measured were LDL, or 'bad' cholesterol, and lipoprotein(a), which is partly made of LDL. Inflammation was measured by detecting levels of high-sensitivity C-reactive proteins.

When the three measures -- inflammation, cholesterol and lipoprotein(a) -- of a woman's blood sample were analysed together, researchers found that women having the highest levels were 2.6 times more likely to have a major adverse cardiovascular event, including a heart attack.

The link was found to be even stronger for stroke -- women with the most elevated levels were 3.7 times more likely to experience a stroke over the next 30 years, the team of researchers, including those from Brigham and Women's Hospital, US, said.

They added that the three measures can better predict the risk of major cardiovascular events over the next three decades than measuring only one. The findings were published in the New England Journal of Medicine.

"We can't treat what we don't measure, and we hope these findings move the field closer to identifying even earlier ways to detect and prevent heart disease," author Paul M Ridker, Brigham and Women's Hospital, said.

For the study, the researchers analysed blood samples and medical information from 27,939 healthcare providers living in the US, who participated in the Women's Health Study. The women were on average aged 55 at the study's start (1992-1995) and followed for 30 years.

Over the study period, about 3,660 of the women experienced a major cardiovascular event for the first time, including a heart attack, stroke, or death due to related reasons.

Assessing cardiovascular risk individually due to each of the three measures, the researchers found that the women having the highest levels of inflammation had a 70 per cent higher chance of a major cardiovascular event.

The women with the highest levels of 'bad' cholesterol and lipoprotein(a) were found to be at a 36 per cent and 33 per cent higher chance, respectively, of developing heart-related conditions.

While only women were studied for this research, the researchers expect to find similar results in men, they said.

Studies in recent years have shown how high levels of inflammation can interact with fats to compound heart disease risks, which helps explain why lower levels are better, according to the researchers.

They explained that immune cells, which help the body repair wounds or infection, can also sense the accumulation of extra cholesterol in cells or become active in response to the build-up of plaque and send out inflammatory signals.

This creates a hyper-inflammatory environment where plaque can form, become larger, or even rupture -- and cause cardiovascular events, the authors said.

Through a combination of lifestyle changes and drug therapy, the researchers said that each of the three risk factors can be addressed.

Studies have shown that lowering cholesterol and inflammation both significantly reduce the risk of heart attack and stroke, they said.

The new data strongly supports earlier and more aggressive use of targeted preventive interventions, particularly among women for whom cardiovascular disease remains under-diagnosed and under-treated, the researchers said.