Women’s heart disease risks and their need to start taking preventive medications should be evaluated when they are in their 30s rather than well after menopause as is now the practice, said researchers who published a study yesterday.
Presenting the findings at the European Society of Cardiology’s annual meeting in London, they said the study showed for the first time that blood tests make it possible to estimate a woman’s risk of cardiovascular disease over the following three decades.
“This is good for patients first and foremost, but it is also important information for [manufacturers of] cholesterol lowering drugs, anti-inflammatory drugs and lipoprotein(a)-lowering drugs — the implications for therapy are broad,” said Paul Ridker of Brigham and Women’s Hospital in Boston, the study leader.
Current guidelines “suggest to physicians that women should generally not be considered for preventive therapies until their 60s and 70s. These new data ... clearly demonstrate that our guidelines need to change,” Ridker said. “We must move beyond discussions of five or 10 year risk.”
The 27,939 participants in the long-term Women’s Health Initiative study had blood tests between 1992 and 1995 for low-density lipoprotein cholesterol (LDL-C or “bad cholesterol”), which are already a part of routine care.
They also had tests for high-sensitivity C-reactive protein (hsCRP) — a marker of blood vessel inflammation — and lipoprotein(a), a genetically determined type of fat.
Compared with risks in women with the lowest levels of each marker, risks for major cardiovascular events like heart attacks or strokes over the following 30 years were 36 percent higher in women with the highest levels of LDL-C, 70 percent higher in women with the highest levels of hsCRP and 33 percent higher in those with the highest levels of lipoprotein(a).
Women in whom all three markers were in the highest range were 2.6 times more likely to have a major cardiovascular event and 3.7 times more likely to have a stroke over the following three decades, said a report of the study in The New England Journal of Medicine that was published to coincide with the presentation at the meeting.
“The three biomarkers are fully independent of each other and tell us about different biologic issues each individual woman faces,” Ridker said. “The therapies we might use in response to an elevation in each biomarker are markedly different and physicians can now specifically target the individual person’s biologic problem.”
While drugs that lower LDL-C and hsCRP are widely available — including statins, and pills for high blood pressure and heart failure — drugs that reduce lipoprotein(a) levels are still in development by companies, including Novartis, Amgen, Eli Lilly and London-based Silence Therapeutics.
Lifestyle changes such as exercising and quitting smoking can also be helpful.
Most of the women in the study were white Americans, but the findings would likely “have even greater impact among black and Hispanic women for whom there is even a higher prevalence of undetected and untreated inflammation,” Ridker said.
“This is a global problem,” he added. “We need universal screening for hsCRP ... and for lipoprotein(a), just as we already have universal screening for cholesterol.”
A fire caused by a burst gas pipe yesterday spread to several homes and sent a fireball soaring into the sky outside Malaysia’s largest city, injuring more than 100 people. The towering inferno near a gas station in Putra Heights outside Kuala Lumpur was visible for kilometers and lasted for several hours. It happened during a public holiday as Muslims, who are the majority in Malaysia, celebrate the second day of Eid al-Fitr. National oil company Petronas said the fire started at one of its gas pipelines at 8:10am and the affected pipeline was later isolated. Disaster management officials said shutting the
US Vice President J.D. Vance on Friday accused Denmark of not having done enough to protect Greenland, when he visited the strategically placed and resource-rich Danish territory coveted by US President Donald Trump. Vance made his comment during a trip to the Pituffik Space Base in northwestern Greenland, a visit viewed by Copenhagen and Nuuk as a provocation. “Our message to Denmark is very simple: You have not done a good job by the people of Greenland,” Vance told a news conference. “You have under-invested in the people of Greenland, and you have under-invested in the security architecture of this
UNREST: The authorities in Turkey arrested 13 Turkish journalists in five days, deported a BBC correspondent and on Thursday arrested a reporter from Sweden Waving flags and chanting slogans, many hundreds of thousands of anti-government demonstrators on Saturday rallied in Istanbul, Turkey, in defence of democracy after the arrest of Istanbul Mayor Ekrem Imamoglu which sparked Turkey’s worst street unrest in more than a decade. Under a cloudless blue sky, vast crowds gathered in Maltepe on the Asian side of Turkey’s biggest city on the eve of the Eid al-Fitr celebration which started yesterday, marking the end of Ramadan. Ozgur Ozel, chairman of the main opposition Republican People’s Party (CHP), which organized the rally, said there were 2.2 million people in the crowd, but
JOINT EFFORTS: The three countries have been strengthening an alliance and pressing efforts to bolster deterrence against Beijing’s assertiveness in the South China Sea The US, Japan and the Philippines on Friday staged joint naval drills to boost crisis readiness off a disputed South China Sea shoal as a Chinese military ship kept watch from a distance. The Chinese frigate attempted to get closer to the waters, where the warships and aircraft from the three allied countries were undertaking maneuvers off the Scarborough Shoal — also known as Huangyan Island (黃岩島) and claimed by Taiwan and China — in an unsettling moment but it was warned by a Philippine frigate by radio and kept away. “There was a time when they attempted to maneuver
RSS