A Simple Blood Test Predicts a Person's Heart Disease Risk 30 Years Out, Study Finds (nbcnews.com) 30
An anonymous Slashdot reader shared this report from NBC News:
A new approach to a routine blood test could predict a person's 30-year risk of heart disease, research published Saturday in the New England Journal of Medicine found.
Doctors have long assessed their patients' risk for cardiovascular disease by using a blood test to look at cholesterol levels, focusing particularly on LDL or "bad" cholesterol. But limiting blood testing to just cholesterol misses important — and usually silent — risk factors, experts say... Lead study author Dr. Paul Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital in Boston and his team found that in addition to LDL cholesterol, two other markers — a type of fat in the blood called lipoprotein (a), or Lp(a), and an indicator of inflammation — are important predictors of a person's risk of heart attack, stroke and coronary heart disease...
In the study, the researchers analyzed data from nearly 30,000 U.S. women who were part of the Women's Health Study. On average, the women were 55 years old when they enrolled in the years 1992 through 1995. About 13% — roughly 3,600 participants — had either a heart attack or stroke, had surgery to fix a narrowed or blocked artery, or died from heart disease over the 30-year follow-up period... All of the women had blood tests done at the beginning of the study to measure their LDL cholesterol, Lp(a) and C-reactive protein levels, a marker of inflammation in the body. These measurements, individually as well as together, appeared to predict a woman's heart health over the next three decades, the study found.
Women with the highest levels of LDL cholesterol had a 36% higher risk for heart disease compared with those with the lowest levels. The highest levels of Lp(a) indicated a 33% elevated risk, and those with the highest levels of CRP were 70% more at risk for heart disease. When the three were looked at together, women who had the highest levels were 1.5 times more likely to have a stroke and over three times more likely to develop coronary heart disease over the next 30 years compared with women with the lowest levels.
All of the markers have been individually linked to higher risk of heart disease, but "all three represent different biological processes. They tell us why someone is actually at risk," Ridker said.
Doctors have long assessed their patients' risk for cardiovascular disease by using a blood test to look at cholesterol levels, focusing particularly on LDL or "bad" cholesterol. But limiting blood testing to just cholesterol misses important — and usually silent — risk factors, experts say... Lead study author Dr. Paul Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital in Boston and his team found that in addition to LDL cholesterol, two other markers — a type of fat in the blood called lipoprotein (a), or Lp(a), and an indicator of inflammation — are important predictors of a person's risk of heart attack, stroke and coronary heart disease...
In the study, the researchers analyzed data from nearly 30,000 U.S. women who were part of the Women's Health Study. On average, the women were 55 years old when they enrolled in the years 1992 through 1995. About 13% — roughly 3,600 participants — had either a heart attack or stroke, had surgery to fix a narrowed or blocked artery, or died from heart disease over the 30-year follow-up period... All of the women had blood tests done at the beginning of the study to measure their LDL cholesterol, Lp(a) and C-reactive protein levels, a marker of inflammation in the body. These measurements, individually as well as together, appeared to predict a woman's heart health over the next three decades, the study found.
Women with the highest levels of LDL cholesterol had a 36% higher risk for heart disease compared with those with the lowest levels. The highest levels of Lp(a) indicated a 33% elevated risk, and those with the highest levels of CRP were 70% more at risk for heart disease. When the three were looked at together, women who had the highest levels were 1.5 times more likely to have a stroke and over three times more likely to develop coronary heart disease over the next 30 years compared with women with the lowest levels.
All of the markers have been individually linked to higher risk of heart disease, but "all three represent different biological processes. They tell us why someone is actually at risk," Ridker said.
What's new? (Score:4, Informative)
New title (Score:4, Interesting)
"A Simple Blood Test Raises People's Insurance With No Recourse"
Even if the test is flawed, how can a victim prove it?
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Checks the women most affected, men excluded slant (Score:3)
Let's run the usual health news checks on this https://www.nbcnews.com/health... [nbcnews.com]
This one-sided focus on half the population, treating their health problems as worthy of research, news reporting and government/taxpayer funded programs is harmful to the other half of the population.
Lead in promise: "A new approach to a routine blood test could predict a person’s 30-year risk of heart disease"
Reporter name: Kaitlin S.
Pretend equality disclaimer statement: "Though the research was done in women, Ridker sa
And government funded women's only research again (Score:2)
When and how can we get government funded research focused on men's health, studies which only research using data from men and focus on better health outcomes for men - like addressing the lifespan gap where men live 5 years shorter lives than women.
The study is government supported women's only research: https://www.nejm.org/doi/full/... [nejm.org]
Supported by grants (HL043851, HL080467, and HL099355) from the National Heart, Lung, and Blood Institute and grants (CA047988 and CA182913) from the National Cancer Insti
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But most Dr that specializes in cholesterol tests will tell you that LDL by itself is worthless because not all low density lipids are harmful. They will say you actually need a more expensive particle test to know if you actually have a dangerous amount of risky lipids to say for certain. There are also some harmful high density lipids as well. Too much Omega-6 can be pretty harmful and a balanced 3-to-6 ratio is preferred. One (3) reduces inflammation while the other (6) causes it.
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Most doctors ordering these tests for anything other than just screening would order a cholesterol profile (which is usually LDL, HDL, and calculated LDL/HDL ratio), and total cholesterol. A more comprehensive profile would be LDL, HDL, cholesterol, VLDL, triglycerides, Lp(a),ApoB, and a hs-CRP. But the OP point remains that these are tests that are (should be) normally ordered as part of a full screening. Of course, you also want thyroid tests, A1c, etc.
Unfortunately, sometimes with the HMOs out there it'
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I’ve seen the way the claims pay out. Most of the lipid profile test only pay three or four dollars per test. You can go to the Kroger pharmacy and get them done and the results come back in like 20 minutes. They are only expensive because some jackass wants to overcharge for them. I’m sure at one time it took a team of scientist and microscopes to do this crap but advances in technology have made them not so expensive. Sadly laboratories want to hold on pricing from a more complicated method an
Re:What's new? (Score:5, Informative)
Warning: Rant incoming.
You're completely right. The entire thing is a bit more complicated. (If you think I disagree with you, I don't. Keep reading.) If I run a doctor's office and I'm the only doctor there, I need to lease the property, get the equipment, hire at least a receptionist and a medical assistant, have some way to replace them on short notice if one or both decide not to show up, pay the utilities, and pay for insurance. That's a minimum. Not included in that is all the bullshit put on the doctor personally like malpractice insurance, licensing fees, fees for professional organizations(*) that he may not even want to be a part of, certification fees(**), and so on. So like any business, there is a hidden overhead to the entire thing, and with medicine a lot of it isn't what you'd necessarily expect, because the doctor, who is the business really, has a load of crap thrown on him too.
So then someone comes in. If they want to pay cash, great. The doctor cuts them some kind of deal (if he's decent). This is because if you come in and claim insurance of any kind, including Medicaid or Medicare, there's a large hidden cost in the background there too. So now the doctor has to either hire his own billers, or more likely contract out to some agency that is going to charge a monthly fee and take a certain percentage of whatever he gets back. If the doctor charges $100 for something to an insurance company, there are a few things that go on. He may get $100, but could he have collected $200 instead? They may only pay some percentage of what he charges up to some maximum (probably most common) so he only gets $60, where if he charged $500 he might get $200. This sick game goes on and on.
So in a lot of ways, it's like taking your car into the mechanic. The mechanic has to diagnose the car, which isn't free. Then he presents you with an estimate. You take the estimate and he works on the car. It takes $x in parts. But most of the cost is $y in labor. During the entire process, something else comes up and he has to address another problem so he calls you. You agree to pay $z extra for extra parts and labor. There's always the possibility that there's another problem that didn't present itself and comes up later. People understand this (mostly) with cars, but with healthcare they sue the doctor five years later because they came in for an ingrown toenail and the next week were diagnosed with type II diabetes.
The entire healthcare system is broken. We all know that. I've had to argue with insurance companies about all sorts of stuff. But you still get the person who comes in and says that they want some random test that doesn't affect their outcome at all. When you tell them that it isn't medically indicated and the insurance won't cover it, they inevitably say "Oh, I'll pay for it." The doctor explains again that it isn't necessary, but they start looking like they'd be litigious. So the doctor orders the test and covers himself. Goes great until they get the bill from the imaging company. Then they're slapped with a $4000 bill for a completely unnecessary MRI that it's documented that they demanded despite medical advice to the contrary, and they start spewing complaints which are warrantless, etc. (That's where the doctor's malpractice comes in again, to defend against stupid complaints. You're going to get a lawyer every time, who is going to fleece the insurance company for no less than $8000 to handle it. This raises everyone's insurance rates... wash, rinse, repeat.)
If the average person knew just how screwed up the American healthcare system was, they would riot. That's because it isn't just the normal level of screwness. It's epic. It's a pyramid. At the bottom, of course, you have the patients. Then you have the "providers" (doctors, nurse practitioners, physician assistants). Then you have the insurance companies, etc., and at the top the lawyers.
I've seen it on both sides. Recently I had an accident in my house and fell. I briefly lost consciousness. I wound up
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I like that you used the car repair example. There is a book that says for a given repair, you can only charge X number of hours in labor. Thats how insurance works too. For every CPT code there is an allowable contracted amount. Out of all the healthcare systems out there, I have decided the French method is the fairest from preventing abuse and misuse. They made their list of maximum amounts for every procedure. The government pays 70% and you pay 30%. The 30% serves as a deterrent so people don’t o
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Thank you.
I can't count the number of times I have read a comment here about medical costs and bills and doctors charges - and then wanted to write an explanatory comment like you just did. But, then I get lazy.
But, you wrote it.
I hope others now understand how little of the money they spend goes for the true direct service versus add-on "taxes" so that others can suck money out of the system.
When people read that American health care costs ## trillions of dollars, they do not realize that that includes ne
Re:What's new? (Score:4, Informative)
If the average person knew just how screwed up the American healthcare system was, they would riot.
That is the idealist in you saying that. In reality, people are too complacent to care, or the system is so convoluted and arcane that the average reasonable person cannot understand it well enough to even know when they are being ripped off or that there must be a better way or even where to go to complain. Furthermore, people do not want to know about the healthcare system. They interact with it only at times of fear and duress - when they are sick or injured - when all they care about is getting better, so they accept whatever charges come along not knowing the things you wrote about. If their beer or sneakers or groceries or titty magazines had inflated prices like medicine, there would be riots, but not for medicine. Sad.
Thanks again for the great post - you spoke for all of us.
Thanks for the praise. I too have thought about writing about this many times, but more often than not people on Slashdot get downmodded into oblivion because their opinion doesn't fit the popular narrative. This seems odd for a site of self-professed nerds.
Whenever people start critisizing healthcare, they inevitably (maybe even subconsciously) start to blame doctors. Doctors aren't rich. Four years of college and four years of medical school, all on loan. Then they get a "job" as a resident where they work inhumane hours (30 hour shifts that the program can easily extend to 36) for something like $50,000/yr. Once you figure the hourly compensation they're getting, most people would think that they're insane. It's particularly hard if you're a woman, because those are your prime fertile years, so maybe the "grrl power" people might want to think about that. Then after it's all done, you're at least about 29-30, and now you're saddled with all this debt, and are now starting at where your CS classmate was at 22. Go back to your basic economics course in high school and think about "opportunity cost."
The people who do make out like bandits? Insurance companies, pharmaceutical companies, the cottage industries you mention, lawyers, sometimes divorce lawyers and ex-spouses...but not the people doing the actual work.
With the pandemic in the rearview, there are a lot of doctors out there that have run afoul of the guild fees and nonsense certification fees and are having problems finding work. I talk to them every week or so. What's more ridiculous is the American Board of Medical Examiners (ABMS) -- sounds official, right? It's a private cartel -- and their bizarre idea that their tests for certification are meaningful (but they have a disclaimer that they aren't), but you can't even take the damned things if you've "timed out" which is what a whole lot of people have done. As a result, you have a lot of doctors who aren't "board certified' but also aren't allowed to take the damned board exam because, uh, I guess, reasons. So you conceivably have a qualified doctor who was saving your life in the ER yesterday who, after midnight, suddenly is unemployable and suddenly not "competent" because some date passed.
For reference, one person I talked to said that to become "board-eligible" again (meaning able to take the test) she would have to pay about $15,000 to some university program, go through psychological testing(!) and travel several hundred miles for two days to do so, then spend six months working as a glorified resident somewhere, and then be given the privilege of paying $2500 (and the previously mentioned $4000 for study materials) to take the test. Which is only given once a year. And you have to find your own "sponsor" as if this is Narcotics Anonymous or something. Actually, I think they even give you assistance to match a sponsor, unlike this place. And if your mother dies a day before that test is given, then too bad. You lose your fee and get to wait another year. People in other fields would not believe the crap that do
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But a big one is the liability. If the doctor screws up and kills your animal--or if the doctor doesn't screw up but a lawyer can convince a jury that (s)he did, the patient wins. They can get their cost of care & cost of replacing the animal as an award. In other words--they can get a re
Seems like inflammation is the new thing (Score:2)
A lot of medical stuff filtering through the pop media seems to be mentioning long term low-grade inflammation as a key indicator, and we've even had one study showing that suppressing that extends lifespan significantly in lab animals.
Cool. Now we need to figure out why the human body so often ends up in a state where it is triggering a minor inflammation response for long periods and target that (the cause, rather than the symptom that causes other issues).
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The short answer is omega-6 causes inflammation and our diet is full of it. The receptor sites for omega-3 and omega-6 are the same sites. When you have too much omega six, you displace the omega-3. One very simple observation this this is occurring in your body is dry eyes. And sometimes dry lips. One of the easiest, but not so pleasant cures for dry eyes is to take 4g or 4000 mg of omega-3 per day. But those fish burps are not pleasant. If you have deep pockets, eat a lot of salmon sashimi per day. That
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Not a huge fan but sounds like a good plan. Anchovies are the devil. Lol. I had a roommate once that love the damn things on pizza. It didn’t matter if it was on the pizza or in a cup next to the pizza all night long I had a sore throat and a cottonmouth. Those damn things just suck every ounce of fluid out of your body. It’s gotta be something in the skin or something like anchovie mist or something. As a prank in the navy, they sold sardines in the ship store. During high seas, we would go bu
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Two answers in addition to the one's already posted.
1) Fat tends to support inflammation, so if you have more fat on your body, you'll have a greater tendency to chronic inflammation.
2) Getting older tends to support inflammation. So as you get older, you will have a greater tendency to chronic inflammation.
I'll acknowledge that those are both rather useless answers, but they're also true. (I suspect that part of the "getting older" problem is the increased presence of senescent cells, but getting rid of
Re:Seems like inflammation is the new thing (Score:4, Informative)
I gather from your comment that you are not in the medical fields, but yours is one of the best and most insightful in this thread. Others who responded to you - some not so much. I hope you don't mind some clarification.
Seems like inflammation is the new thing.
You are right. Inflammation is not new, but our appreciation of "chronic inflammation" as a vector of chronic disease has garnered a lot of attention over the past 20-30 years.
A lot of medical stuff filtering through the pop media seems to be mentioning long term low-grade inflammation as a key indicator, and we've even had one study showing that suppressing that extends lifespan significantly in lab animals.
It is not just the pop media. This has gotten a lot of attention in biomedical research and clinical care over the past two decades. What filters into the pop media is the proverbial "tip of the iceberg".
A respondent to your post is Valgrus Thunderaxe who wrote "It's another non-specific term, like 'toxins' or 'natural', and the proponents of the 'inflammation' hypothesis, when put under the gun, are never able to actually articulate what specific type of inflammation they're actually talking about or what the cause is."
It is a wrong comment but raises pertinent points. The term inflammation is specific, but the biology of inflammation is quite complex and multi-faceted, with many chemicals, cells, and non-linear dynamical interactions. In its simplest, inflammation is the body's defense system - how the body responds to any adverse challenge. But, adversity can come in many forms - mechanical trauma, thermal or photonic injury, challenge by foreign chemicals, micro-biological assault, and others. Inflammation has many ways to respond to challenge, each "subroutine" tuned to defend against these different categories of injury.
Furthermore, inflammation has two main arms which are part of a broader injury-repair response. The first arm of inflammation per se, the afferent arm, responds to injury to suppress or eliminate the challenge. The downstream efferent arm cleans up the residual damage and debris. This prepares the zone of injury for the repair phase in which the integrity, stability, and function of injured tissues is restored. Thus, the sequence is [inflammation (injury defense > debris cleanup] > [wound repair]. The complexity and technicalities of this rarely make their way into lay and pop media, which is why certain respondents to this thread are excusably uninformed on the subject.
Also, inflammation is generally divided into "acute" and "chronic". Acute inflammation is activated, amplified, and mediated by platelets and neutrophils. It is very generic, non-specific, and inherently destructive, how the body rapidly responds to any threat. (Mast cells mediating inflammation in response to chemical challenges, i.e. allergy, is another lesser aspect of this.) It is either there or not. It runs its course, does its job, then goes away. Chronic inflammation is mediated by lymphocytes, plasma cells, and eosinophils, i.e immune system cells which provide for long term monitoring and rapid response to resurgent long term pathogens. Chronic lympho-plasmacytic inflammation persists. It may go quiet, but it leaves behind "tertiary lymphoid" deposits which are antibody producing immune cells which stay resident in the tissues, waiting to respond to future challenges. They can be reactivated for many other non-specific reasons. For instance, circulating chemistry from acute inflammation in response to a cold or flu or an allergy exposure or a broken ankle can turn on those old plasma cells from prior chronic inflammation. They in turn trigger acute inflammation at their site of prior pathology, and problems long quiet flare up. Such chronic inflammation leads to the many well defined diseases that each organ system, but also vague, ill-defined, hard to diagnose seemingly "non-specific illness. When these events involve t
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I am not sure how much of that I will permanently retain, but thank you for taking the time to post it.
Missing (Score:3)
Would like to know what fraction of women who had heart attacks and/or stroke had not tested positive for the risk factors (what is the rate of false negatives?), and also what fraction of the women who DIDN't have heart attacks or strokes had tested positive for the risk factors (what is the rate of false positives?).
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None of that’s missing.
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None of that’s missing.
Well, for most doctors, that info is not missing. For most people on slashdot, the info is definitely missing because the paper is paywalled.
Because we cover up, not fix issues. (Score:2)
Take 'antihistamines'... They just prevent our body from noticing all the histamine flying around. "Ignore the source of the problem... We're going to `solve` the symptom, and ignore the rest." I mean what else is profitable?
Maybe old doctors aren't the best judge of what new doctors should learn and do?
Maybe continuing education credits aren't enough to keep all doctors relevant?
Maybe we don't teach enough about nutrition and diet to make MD's effective? ...
misleading (Score:3)
> highest levels of LDL
Yeah - a heritable genetic disease causes super high cholesterol AND heart disease and both have a common cause.
You need to take those out and do standard deviations on the normal.
Almost everybody is below 300 but the disease group is 800+ .
A high CRP indicates inflammation and almost always a high sugar diet and is comorbid with metabolic syndrome.
This is all still slow-rolling the fact that sugar is harmful and fat is healthy and Big Sugar and USDA paid off Harvard scientists in the 1970's to fabricate evidence which led to the deadly Food Pyramid.
Or they were trying to avoid Social Security insolvency - pick your poison.
I mean it's good that a 30,000-woman study confirms what informed cardiologists have been saying for two decades but nobody is surprised.
CRP due to another cause (Score:1)
It's not clear how to interpret an elevated CRP as a marker of blood vessel inflammation when one has a pre-existing inflammatory condition such as IBD.