The risk was 33 percent higher for women with the highest Lp(a) levels, and a 70 percent increased risk was found for women with the highest CRP levels. When all three measurements, i.e. LDL cholesterol, Lp(a) and CRP, were assessed together, the women with the highest levels had a more than 1.5-fold increased risk of stroke and a more than 3-fold increased risk of coronary heart disease compared to women with the lowest levels.
Study co-author Dr. Paul M. Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital in Boston, says: “What we cannot measure, we cannot treat. Our study findings will hopefully help to advance and improve early detection of heart disease.” For long-term heart health, he and his team recommend the (actually) well-known suspects: prevention through exercise, a healthy diet, good stress management, and avoiding tobacco.
Spain’s study on CHIP and atherosclerosis
All things that researchers in Germany would also recommend, having looked at a study from Spain that also focused on blood, but in relation to atherosclerosis. The CHIP phenomenon, which can accompany the body’s aging process, means, to put it simply, that the heart is not supplied with enough oxygen. This happens when the artery walls are covered with plaque, i.e. deposits that impede blood flow. And when a certain amount of mutated blood cells are present in the blood, this is referred to as the CHIP phenomenon.
Until now, it had not been sufficiently clarified whether and how CHIP and cardiovascular diseases are related. For the study from Spain, the almost 3,700 participants were examined three times over the course of six years. The analysis of their blood values showed that those with CHIP had a 2.1-fold increased risk of developing atherosclerosis in the femoral artery within three years. Conversely, however, it was not found that people who already had atherosclerosis developed more mutated blood cells.
How do other researchers evaluate the study: breakthrough? Partial success? What is missing?
The study has received a mixed response in German-speaking research. Prof. Dr. Christoph Binder from the Center for Molecular Medicine of the Austrian Academy of Sciences is researching atherosclerosis. He criticizes the fact that the extent of the disease in this relatively young cohort with an average age of 55 is still too small to prove this effect, i.e. the fueling of the expansion rate of mutations through atherosclerosis. In his opinion, the approach focuses too much on the visible spread of mutations in the blood, and the formation of mutated clones in the bone marrow was left out of the analysis.
According to Professor Dr. Stefanie Dimmeler, Director of the Institute for Cardiovascular Regeneration in Frankfurt am Main, the study confirms that CHIP promotes atherosclerosis. This means that CHIP could be one of the previously unknown additional ‘unmodifiable’ risk factors and play an important role in prevention. Dr. Moritz von Scheidt, a cardiologist at the German Heart Center in Munich, takes a similar view. He believes that crucial new findings have been found about the temporal connection between CHIP and atherosclerosis.
However, the analysis was limited to a homogeneous ethnic group, so the results cannot be generally applied. The focus on common mutations also does not allow any statement to be made about the potential effects of rare CH mutations. If CH were detected early, says von Scheidt, targeted prevention strategies could be developed and applied before someone develops cardiovascular disease: for example, with screenings in certain population groups at risk.
