Forget cholesterol - different hidden killer protein can better predict heart attacks, 'mind-blowing' research suggests

High cholesterol is a less important indicator of heart attack and stroke in women than other subtle signs, a new study suggests.

Medics have long used measurements of cholesterol, a fatty, waxy substance found in blood, as indicator for potential cardiovascular disease. 

But a new study on 28,000 American women in their mid-40s suggests cholesterol isn't the biggest indicator of heart attack and stroke risk.

Instead, high levels of a substance called high-sensitivity C-reactive protein (hsCRP), picked up in high levels in a blood test, could be a better indicator of dangerous levels of inflammation in the body. 

Experts from Brigham and Women’s Hospital in Boston, Massachusetts found women with high levels of hsCRP had a 70 per cent greater risk of a major cardiovascular event, like a heart attack. 

A new study on 28,000 American women in their mid-40s suggests cholesterol isn't the biggest indicator of risk from heart and strokes, one of Britain's biggest killers. Stock image

Results from the Our Future Health project demonstrating levels of high cholesterol in the population based on a sample of 227,592 volunteers. Source: Our Future Health  

In comparison, those with higher levels of bad cholesterol only had a 36 per cent greater risk.

They also tested another factor called lipoprotein(a) — a type of fat in the blood that is determined by a person's genes, and found high levels were linked to a 33 per cent increased risk. 

But experts were keen to point out hsCRP being a stronger indicator of serious heart disease doesn't mean people should ignore their cholesterol.

Presenting their findings at the presented at the European Society of Cardiology Congress in London and publishing them in the New England Journal of Medicine, the authors said women with elevated levels of all three substances had a 2.6 times higher risk of a major adverse cardiovascular event, such as heart failure.

Results were even starker when looking at stroke, with women with elevated levels of the three substances at a 3.7 times higher risk of such a life-threatening event in the next 30 years, compared to those who didn't. 

Results of the new study were based on blood tests measuring the three factors in women aged 45 who were followed since 1993.  

Julie Buring, an epidemiologist at Brigham and co-author of the new study, said the results should be a 'wake-up call' for medics and women alike.  

'Waiting until women are in their 60s and 70s to initiate heart attack and stroke prevention is a prescription for failure,' she said. 

Dr Paul Ridker, an expert in cardiovascular disease prevention at Brigham and lead author of the study, added: 'Doctors cannot treat what they don’t measure'. 

'To provide the best care for our patients, we need universal screening for inflammation, cholesterol, and lipoprotein(a), and we need it now. 

'By so doing, we can target our treatments to the specific biologic need of individual patients, fulfilling our longstanding hope to provide truly personalized preventive care'.   

When medics talk about bad cholesterol they are specifically referring to a type called low-density lipoprotein, which is linked to dangerous fatty deposits around the arteries.

In contrast, 'good' cholesterol, technically called high-density lipoprotein, picks up excess cholesterol and take it to the liver where it broken down and removed from the body. 

Brits have been urged for years to keep an eye on their bad cholesterol and reduce their risk by eating fewer fatty foods, exercising more and cutting down on smoking and drinking. 

Medications like statins, a daily pill taken by about 8million Brits, can also be prescribed to help lower cholesterol.  

hsCRP levels can rise in response to non-cardiovascular health related causes of inflammation in the body, such as an infection or injury, and things like obesity and smoking.

Advice to lower them depends on the cause but improving cardiovascular health in general, such as adhering to healthy diet and exercising regularly, is recommended. 

Some statins have also been found to lower hsCRP levels.

The authors said their results supported the use of earlier and more aggressive use of interventions, both of lifestyle changes and drugs, to improve cardiovascular health.

Dr Ridker said: 'While we still need to focus on lifestyle essentials like diet, exercise, and smoking cessation, the future of prevention is clearly going to include combination therapies that target inflammation and Lp(a) in addition to cholesterol.' 

Cardiovascular disease causes about a quarter of all deaths in the UK, some 170,000 deaths each year.

That about 480 deaths a day, or one every three minutes according to the British Heart Foundation.