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New Study Shows 3 Blood Biomarkers That Predict 30-Year Risk Of Heart Attack & Stroke In Women
Cardiovascular disease is the leading cause of death worldwide1—including for women— while stroke is the third leading cause for women in the U.S. For women approaching their 50s, it's essential to pay attention to heart health, as the risk for complications goes up even more after menopause2. It’s vital that we (and our healthcare providers) can identify early warning signs and the best course of action to prevent events like heart attacks and strokes—because lifestyle habits can alter the course of those events.
Researchers at Brigham and Women’s Hospital recently investigated whether three pretty common blood tests could be used to predict cardiovascular disease decades later3. And results of that study (published in the New England Journal Of Medicine) clearly showed a strong association.
Here’s what you need to know.
About the study
For this study, researchers measured three blood biomarkers—high-sensitivity c-reactive protein or hsCRP, LDL cholesterol, and lipoprotein(a)—in over 28,000 women around the age of 55 at the start of the study and followed them over 30 years. The goal was to track the number of cardiovascular events that occurred over the years (including heart attacks, strokes, and heart-related deaths).
And before we dive any further into the study, let’s go over what these three biomarkers measure (and why the researchers hypothesized they could be good to measure)
- hsCRP: This is an established, general marker of inflammation4—meaning it doesn’t specify the exact source of the inflammation. However, heaps of research shows that chronically high levels are linked to an increased risk of heart disease (and other chronic conditions). This marker is impacted by lifestyle habits.
- LDL cholesterol: LDL often gets the nickname of “bad” cholesterol as it carries cholesterol to the arteries5. High levels can lead to plaque buildup which may then lead to heart disease or stroke. And high LDL levels in the presence of inflammation are especially concerning. This marker is impacted by lifestyle habits.
- Lipoprotein(a): This particle carries fat and cholesterol to the arteries. But this is a genetic marker—meaning elevated levels (linked to heart disease risk) are genetically determined6 and therefore aren’t positively or negatively impacted by lifestyle.
Researchers of this study specifically wanted to evaluate how well each of these markers performed at predicting cardiovascular risk alone and when considered together when someone is healthy.
The women were divided into five groups for each biomarker (and a combined score) based on their baseline levels of three biomarkers to compare low versus high values.
Blood biomarkers and risk of CVD for women 50+
Results showed that women with the highest levels of each biomarker were at a significantly increased risk for experiencing a cardiovascular event than those with the lowest levels.
- Highest CRP raised risk by 70%
- Highest LDL levels raised risk by 36%
- Highest lipoprotein(a) levels raised risk by 33%
However, the most accurate prediction of cardiovascular risk came from models that pooled all three biomarkers together. Women with levels of all biomarkers were 2.6 times as likely to have a cardiovascular event and 3.7 more likely to have a stroke over 30 years.
Why does this matter?
Cardiovascular disease can be misdiagnosed (or undiagnosed) in women because their symptoms appear different than men’s (as women have been notoriously understudied in scientific research for decades).
While only one of these three biomarkers is regularly assessed as part of routine screenings (LDL cholesterol), it is possible to talk with your doctor about getting hsCRP and lipoprotein(a) measured if you have concerns. And it’s studies like this that will hopefully pave the way for those two tests to be more accessible and (and covered by insurance).
Knowing these three markers and tracking LDL and hsCRP over time (as lipoprotein(a) is genetically determined it doesn’t change and you only need to have it measured once), lets you identify potential risks early on and make the appropriate lifestyle changes that can shift the course of your health.
How to improve LDL cholesterol and hsCRP
These are the two biomarkers your lifestyle habits can have a drastic effect on. Here’s some general advice on science-backed ways to improve them.
How to improve your LDL cholesterol:
- Increase your fiber intake: About 95% of Americans7 aren’t getting the recommended amount of fiber (so most of us could bump up our intake). Bump up your intake of fiber-rich foods like fruits, vegetables, and whole grains. You’ll specifically want to focus on sources of soluble fiber, like oats and beans, and this fiber is particularly beneficial at lowering cholesterol. Leaning on a soluble fiber supplement is also a great choice and certain fibers (like those from guar beans) have been clinically shown to reduce high LDL cholesterol levels. Here are our 5 favorite soluble fiber supplements.
- Improve your body composition: For women over the age of 50, body composition often shifts in a way that favors fat storage and muscle loss. This increase in fat can also raise LDL cholesterol levels. To support a healthy body composition (and lose unwanted fat while maintaining muscle) taking up a strength training routine and eating a high-protein diet is important. If you’re not sure where to start, try this at-home strength program and this high-protein meal plan.
How to improve your hsCRP:
- Eat an anti-inflammatory diet: Following an anti-inflammatory diet8 high in antioxidant-rich fruits and vegetables, legumes, nuts, fish, and olive oil (like the Mediterranean diet) helps lower hsCRP levels. This also means avoiding or limiting inflammatory foods like processed meats and ultra-processed foods.
- Try taking a fish oil supplement: Omega-3 fats are known for their antioxidant properties, and research shows that supplementing with 1 to 4 grams of EPA and DHA omega-3s a day can significantly lower hsCRP9 levels. Here are our top picks for omega-3 supplements.
- Move regularly: Both cardio and strength training can help lower hsCRP levels. One study found that regular cardio exercise significantly decreased CRP levels in young women after just 16 weeks10.
The takeaway
This study shows that three simple blood tests are accurate at predicting the long-term risk of heart disease and stroke in women. These blood tests can be easily accessible with the right resources (like insurance and healthcare provider support) and can be used to help guide lifestyle changes to promote overall health.
10 Sources
- https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10074318/
- https://www.nejm.org/doi/full/10.1056/NEJMoa2405182
- https://www.ncbi.nlm.nih.gov/books/NBK441843/
- https://www.ncbi.nlm.nih.gov/books/NBK519561/
- https://www.ncbi.nlm.nih.gov/books/NBK570621/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124841/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954840/
- https://www.nature.com/articles/s41598-019-54535-x
- https://pubmed.ncbi.nlm.nih.gov/21085036/
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