Harvard Women's Health Watch

A better way to predict cardiovascular risk

We know how important cholesterol levels are, but what about inflammation?

Since the 1980s, we've made enormous progress in understanding cardiovascular disease (CVD) in women. Recent findings help explain why CVD (heart disease and stroke) has been more difficult to diagnose and treat in women than in men: Our heart attack symptoms are often different; standard diagnostic tests don't predict our heart problems as reliably; and we may not get as much benefit from such treatments as angioplasty and bypass surgery.

We've also learned much more about the biology of cardiovascular disease. It's not just a matter of cholesterol clogging the arterial plumbing. Low-level inflammation also contributes to the atherosclerotic plaques that can block blood flow to the heart and brain. In 1997, researchers at Boston's Brigham and Women's Hospital found an association between high-sensitivity C-reactive protein (hsCRP) — a marker for inflammation — and the risk of having a heart attack or stroke in healthy men. A test was developed to detect subtle changes in hsCRP, and later research showed that elevated hsCRP also predicted coronary events in women — even when their cholesterol levels and blood pressure were normal.

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