A hidden risk factor may be putting seemingly healthy women at serious risk of heart attacks and strokes, according to a groundbreaking study presented at the European Society of Cardiology Congress in Madrid. The research, published simultaneously in the European Heart Journal, points to inflammation as a silent driver of cardiovascular disease—comparable in impact to high LDL cholesterol.
The study analyzed three decades of data from more than 12,000 women, revealing that inflammation significantly increases the likelihood of heart attacks and strokes, even when traditional risk factors like high cholesterol, smoking, or hypertension appear under control. Dr. Paul Ridker, lead author and preventive cardiologist at Mass General Brigham and Women’s Heart and Vascular Institute, emphasized the importance of these findings.
“Half of all heart attacks and strokes occur in people who do not have any major risk factors,” Ridker noted.
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Inflammation: The Overlooked Risk Factor
Unlike cholesterol or blood pressure, inflammation is not routinely screened in the United States, and it often shows no outward symptoms. Dr. Anais Hausvater, cardiologist and co-director of the Cardio-Obstetrics Research Program at NYU Langone Health, described the study as “potentially practice-changing.”
“Despite growing evidence that inflammation is a critical cardiovascular risk factor, most women are not being screened,” Hausvater said.
An inexpensive blood test known as high-sensitivity C-reactive protein (hsCRP) can measure inflammation. In Europe, hsCRP testing is already a standard part of preventive care, but it remains underutilized in the U.S.
Insights from the Women’s Health Study
The research drew on the Women’s Health Study, a long-term investigation launched by the National Heart, Lung, and Blood Institute in the early 1990s. At the start of the study, participants provided blood samples for cholesterol and hsCRP measurements.
Of nearly 28,000 women who provided baseline blood tests, 12,530 had no standard modifiable risk factors (SMuRFs) for heart disease. Over 30 years of follow-up, 973 cardiovascular events—including heart attacks and strokes—occurred among these women. Those who experienced events had significantly higher hsCRP levels, underscoring inflammation’s critical role.
Dr. Ridker explained that these findings strongly suggest including inflammation in cardiovascular risk screenings. High inflammation levels can be treated with statins, but women with healthy cholesterol levels typically do not qualify for such prescriptions.
Statins for Women with High Inflammation
Previous clinical trials have demonstrated that women without standard risk factors can still benefit from statin therapy. Women with high hsCRP but otherwise healthy profiles saw a 38% reduction in serious cardiovascular events when treated with statins, according to Ridker.
“Physicians will not treat what they don’t measure,” Ridker said, highlighting the life-saving potential of simple hsCRP screening.
Expert Opinions: Screening Should Become Routine
Several cardiologists emphasized the importance of making hsCRP testing routine for women. Dr. Hausvater encouraged patients to proactively ask their doctors for hsCRP testing.
“This is another tool women should be offered to assess their risk,” she said.
Dr. Tania Ruiz, cardiologist and assistant professor at Vanderbilt University Medical Center, described the study as “very exciting” and the first large-scale investigation linking hsCRP with cardiovascular events in otherwise healthy women.
“In recent years, we’ve learned more about how inflammation contributes to plaque formation and vulnerability,” Ruiz said. She added that women with autoimmune diseases, such as lupus, may be especially prone to elevated hsCRP levels. Without testing, there is no reliable way to detect this hidden risk.
Understanding the Role of Inflammation
Inflammation is the body’s natural response to injury or infection. However, chronic low-level inflammation can damage blood vessels, promote plaque buildup, and trigger cardiovascular events. High hsCRP levels indicate systemic inflammation and have now been linked to a substantial risk of heart attacks and strokes—even in people who otherwise appear healthy.
Because standard cardiovascular screenings often overlook inflammation, many women remain unaware of their risk. This gap highlights an urgent need for clinicians to adopt more comprehensive assessments that go beyond cholesterol and blood pressure measurements.
Bridging the Gap in Women’s Heart Health
Historically, women’s cardiovascular health has been under-researched, and symptoms can present differently than in men. This study reinforces that invisible risks, like inflammation, contribute to why women sometimes experience heart attacks and strokes despite appearing healthy.
Routine hsCRP testing could bridge this gap. When combined with lifestyle interventions, medication, and ongoing monitoring, detecting high inflammation early offers a practical strategy to prevent cardiovascular events.
Practical Steps for Women
Women can take several steps to manage cardiovascular risk, including:
- Discussing hsCRP testing with their healthcare provider.
- Maintaining a heart-healthy diet rich in fruits, vegetables, whole grains, and lean protein.
- Engaging in regular physical activity to reduce inflammation.
- Avoiding smoking and limiting alcohol consumption.
- Managing stress through mindfulness, yoga, or other relaxation techniques.
The Future of Cardiovascular Screening
This study underscores a shift in cardiovascular care—from solely tracking cholesterol and blood pressure to addressing systemic inflammation as a major risk factor. By integrating hsCRP testing into routine screenings, clinicians can identify at-risk women earlier and provide targeted interventions, including statins when necessary.
Dr. Ridker stressed the potential impact of wider adoption: “If we measure inflammation, we can prevent thousands of heart attacks and strokes in women who would otherwise go undetected.”
Frequently Asked Questions:
What is the main finding of the 2025 study on women and heart disease?
The study reveals that chronic inflammation, indicated by elevated high-sensitivity C-reactive protein (hsCRP) levels, significantly increases the risk of heart attacks and strokes in women without traditional risk factors like high blood pressure, high cholesterol, diabetes, or smoking. These women, often termed “SMuRF-less,” are frequently overlooked in current cardiovascular risk assessments.
How does inflammation affect heart health in women?
Inflammation can damage blood vessels, promote plaque buildup, and trigger cardiovascular events. Women with high hsCRP levels face up to a 77% increased lifetime risk of coronary heart disease, a 39% increased risk of stroke, and a 52% higher risk of any major cardiovascular event.
Why are women with no traditional risk factors still at risk?
Many women without standard modifiable risk factors remain undiagnosed because current screening tools often exclude inflammation as a risk factor. This oversight leads to missed opportunities for early intervention and prevention.
What is hsCRP, and why is it important?
High-sensitivity C-reactive protein (hsCRP) is a blood marker indicating inflammation levels in the body. Elevated hsCRP levels have been linked to increased cardiovascular risks, even in individuals without traditional risk factors.
Should women request hsCRP testing from their healthcare providers?
Yes, especially if they lack traditional risk factors but have a family history of heart disease or other concerns. Discussing hsCRP testing with a healthcare provider can help identify hidden risks and guide preventive measures.
How can inflammation be managed to reduce cardiovascular risk?
Lifestyle changes such as regular exercise, a heart-healthy diet, stress management, and adequate sleep can lower inflammation levels. Additionally, medications like statins and low-dose colchicine have been shown to reduce inflammation and associated cardiovascular risks.
What are the implications of this study for women’s healthcare?
The study underscores the need for more comprehensive cardiovascular risk assessments in women, including routine hsCRP testing. Early detection of inflammation can lead to timely interventions, potentially preventing heart attacks and strokes in at-risk women.
Conclusion
Inflammation is emerging as a silent but powerful risk factor for heart attacks and strokes in women, even among those who appear healthy and have no traditional risk factors. Elevated hsCRP levels can identify women at hidden risk, offering a critical opportunity for early intervention and prevention. Routine screening for inflammation, combined with lifestyle modifications and, when appropriate, medications like statins, could dramatically reduce cardiovascular events in women. By recognizing and addressing this overlooked factor, healthcare providers can close the gap in women’s heart health and save countless lives.
