Recent research presented at the European Society of Cardiology Congress in Madrid has unveiled the significant role of inflammation as a risk factor for heart disease in women, suggesting that it could explain why some seemingly healthy women suffer heart attacks and strokes.
The study, which analyzed three decades of data from over 12,000 women, revealed that inflammation is just as critical a heart disease risk factor as high LDL cholesterol. These findings were published simultaneously in the European Heart Journal.
The Silent Threat of Inflammation
Inflammation typically goes unnoticed, as it does not present any obvious symptoms, and measuring inflammation levels is not a standard practice in heart disease screening in the United States. According to lead researcher Dr. Paul Ridker, a preventive cardiologist at Mass General Brigham and Women’s Heart and Vascular Institute, inflammation can increase a woman’s risk for cardiovascular events even when other known risk factors—like elevated cholesterol, smoking, and high blood pressure—are absent.
Dr. Ridker noted, “Half of all heart attacks and strokes occur in people who do not have any major risk factors.” This statistic underscores the need for clinicians to consider inflammation as a significant contributor to cardiovascular events.
Call for Routine Screening
Dr. Anais Hausvater, a cardiologist at NYU Langone Health, called the study “potentially practice changing.” She highlighted the growing acknowledgment of inflammation as an essential cardiovascular risk factor and emphasized that many women remain unscreened despite this knowledge. Currently, an inexpensive blood test called high-sensitivity C-reactive protein (hsCRP) can assess inflammation, but it is not routinely performed in the U.S.
In contrast, measuring hsCRP is standard practice in many European countries. Data from the Women’s Health Study, established in the early 1990s, served as the foundation for this research, revealing alarming connections between hsCRP levels and cardiovascular incidents.
Study Insights and Implications
Among nearly 28,000 women who participated in baseline testing, over 12,530 had no standard modifiable risk factors for heart disease, referred to as “SMuRFs.” Throughout the 30-year follow-up period, 973 cardiovascular events occurred in this cohort, with notably higher hsCRP levels recorded in those who suffered such events. This correlation suggests a crucial need to integrate inflammation assessments into cardiovascular screening routines.
Moreover, while high inflammation can be managed with statins, those with healthy cholesterol levels may not receive prescriptions, missing out on necessary treatment. Previous clinical trials indicated that women without standard risk factors but with high inflammation benefited from statin therapy, experiencing a 38% decrease in serious cardiovascular events.
The Importance of Measurement
Dr. Ridker emphasized, “The bottom line is that physicians will not treat what they don’t measure.” This assertion calls for proactive healthcare practices regarding inflammation screening as part of women’s overall cardiovascular health assessments.
Dr. Hausvater concurred, urging that such screenings be routine for all women. “This is another tool women should be offered to assess their risk,” she added, recommending that patients advocate for hsCRP testing during doctor’s visits.
A Broader Context
Dr. Tania Ruiz, a cardiologist at Vanderbilt University Medical Center, also shared the study’s exciting implications, noting it as the first large-scale investigation into hsCRP as a predictor of cardiovascular health in otherwise healthy women. An understanding of inflammation’s role in plaque formation and vulnerability has improved in recent years, reinforcing the importance of this research.
Women with autoimmune conditions, such as lupus, might face a higher likelihood of elevated hsCRP levels, highlighting the necessity for testing. Without it, many women are left uninformed and untreated. This new study aims to shift the conversation around heart disease risk factors and promote a more comprehensive approach to women’s health.
