Nav: Home

Certain heart fat associated with higher risk of heart disease in postmenopausal women

January 30, 2017

PITTSBURGH, Jan. 30, 2017 - A higher volume of a certain type of fat that surrounds the heart is significantly associated with a higher risk of heart disease in women after menopause and women with lower levels of estrogen at midlife, according to new research led by the University of Pittsburgh Graduate School of Public Health.

The findings reveal a previously unknown, menopause-specific indicator of heart disease risk, pointing to potential strategies to reduce that risk and a target for future studies on the impact of hormone replacement therapy in improving cardiovascular health. The results are published online today in the Journal of the American Heart Association.

"For the first time, we've pinpointed the type of heart fat, linked it to a risk factor for heart disease and shown that menopausal status and estrogen levels are critical modifying factors of its associated risk in women," said lead author Samar R. El Khoudary, Ph.D., M.P.H., assistant professor in Pitt Public Health's Department of Epidemiology.

There are two types of fat surrounding the heart:
  • Epicardial fat, the fat that directly covers the heart tissue (the myocardium) and is located between the outside of the heart and the pericardium (the membrane that encases the heart). It is the energy source for the heart.

  • Paracardial fat, which is outside the pericardium, anterior to the epicardial fat. There are no known heart-protective functions of this fat.

El Khoudary and her team evaluated clinical data, including blood samples and heart CT scans, on 478 women from Pittsburgh and Chicago enrolled in the Study of Women's Health Across the Nation (SWAN). The women were in varying stages of menopause, averaged 51 years old and were not on hormone replacement therapy.

In a previous study, the team showed that a greater volume of paracardial fat, but not epicardial fat, after menopause is explained by a decline in the sex hormone estradiol--the most potent estrogen--in midlife women. The higher volume of epicardial fat was tied to other risk factors, such as obesity.

In the new study, the researchers built on those findings to discover that not only is a greater paracardial fat volume specific to menopause, but--in postmenopausal women and women with lower levels of estradiol--it's also associated with a greater risk of coronary artery calcification, an early sign of heart disease that is measured with a heart CT scan.

In the women studied, an increase in paracardial fat volume from the 25th percentile to the 75th percentile (corresponding to 60 percent increase) was associated with a 160 percent higher risk of coronary artery calcification and a 45 percent increase in the extent of coronary artery calcification in postmenopausal women compared with pre- or early-menopausal women.

"Clearly, epicardial and paracardial fat are distinct types of heart fat that are found to be greater in postmenopausal women for different reasons with different effects on heart disease risk--and thus should be evaluated separately when searching for ways to help women avoid heart disease," said El Khoudary.

A recent analysis of previous research found that heart fat volumes could be reduced successfully with dieting and bariatric surgery. Given the uncertainty about the cardio-protective effects of hormone replacement therapy, as well as the lack of research on the impact of such therapy on heart fat volumes, El Khoudary is planning a study to evaluate hormone replacement therapy on heart fat accumulation, paying particular attention to the types of heart fat.
-end-
Additional authors on this study are senior author Karen A. Matthews, Ph.D., of Pitt; and co-authors Kelly J. Shields, Ph.D., of Allegheny Health Network; Imke Janssen, Ph.D., and Lynda H. Powell, Ph.D., both of Rush University Medical Center; Matthew Budoff, M.D., of the Los Angeles Biomedical Research Institute; and Susan A. Everson-Rose, Ph.D., of the University of Minnesota Medical School.

This research was supported by National Institutes of Health grants U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, HL065581 and HL065591; and American Heart Association grant 12CRP11900031.

About the University of Pittsburgh Graduate School of Public Health

The University of Pittsburgh Graduate School of Public Health, founded in 1948 and now one of the top-ranked schools of public health in the United States, conducts research on public health and medical care that improves the lives of millions of people around the world. Pitt Public Health is a leader in devising new methods to prevent and treat cardiovascular diseases, HIV/AIDS, cancer and other important public health problems. For more information about Pitt Public Health, visit the school's Web site at http://www.publichealth.pitt.edu.

http://www.upmc.com/media

University of Pittsburgh Schools of the Health Sciences

Related Heart Disease Articles:

Where you live could determine risk of heart attack, stroke or dying of heart disease
People living in parts of Ontario with better access to preventive health care had lower rates of cardiac events compared to residents of regions with less access, found a new study published in CMAJ (Canadian Medical Association Journal).
Older adults with heart disease can become more independent and heart healthy with physical activity
Improving physical function among older adults with heart disease helps heart health and even the oldest have a better quality of life and greater independence.
Dietary factors associated with substantial proportion of deaths from heart disease, stroke, and disease
Nearly half of all deaths due to heart disease, stroke, and type 2 diabetes in the US in 2012 were associated with suboptimal consumption of certain dietary factors, according to a study appearing in the March 7 issue of JAMA.
Certain heart fat associated with higher risk of heart disease in postmenopausal women
For the first time, researchers have pinpointed a type of heart fat, linked it to a risk factor for heart disease and shown that menopausal status and estrogen levels are critical modifying factors of its associated risk in women.
Maternal chronic disease linked to higher rates of congenital heart disease in babies
Pregnant women with congenital heart defects or type 2 diabetes have a higher risk of giving birth to babies with severe congenital heart disease and should be monitored closely in the prenatal period, according to a study published in CMAJ.
Novel heart valve replacement offers hope for thousands with rheumatic heart disease
A novel heart valve replacement method is revealed today that offers hope for the thousands of patients with rheumatic heart disease who need the procedure each year.
Younger heart attack survivors may face premature heart disease death
For patients age 50 and younger, the risk of premature death after a heart attack has dropped significantly, but their risk is still almost twice as high when compared to the general population, largely due to heart disease and other smoking-related diseases The risk of heart attack can be greatly reduced by quitting smoking, exercising and following a healthy diet.
Citrus fruits could help prevent obesity-related heart disease, liver disease, diabetes
Oranges and other citrus fruits are good for you -- they contain plenty of vitamins and substances, such as antioxidants, that can help keep you healthy.
Gallstone disease may increase heart disease risk
A history of gallstone disease was linked to a 23 percent increased risk of developing coronary heart disease.
Americans are getting heart-healthier: Coronary heart disease decreasing in the US
Coronary heart disease is one of the leading causes of death in the United States.

Related Heart Disease Reading:

Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 2-Volume Set
by Douglas P. Zipes MD (Author), Peter Libby MD PhD (Author), Robert O. Bonow MD MS (Author), Douglas L. Mann MD (Author), Gordon F. Tomaselli MD (Author)

Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure
by Caldwell B. Esselstyn Jr. (Author)

The Prevent and Reverse Heart Disease Cookbook: Over 125 Delicious, Life-Changing, Plant-Based Recipes
by Ann Crile Esselstyn (Author), Jane Esselstyn (Author)

Pathophysiology of Heart Disease: A Collaborative Project of Medical Students and Faculty
by Leonard S. Lilly MD (Author)

The End of Heart Disease: The Eat to Live Plan to Prevent and Reverse Heart Disease
by Joel Fuhrman M.D. (Author)

Illustrated Field Guide to Congenital Heart Disease and Repair - Pocket Sized
by Allen D. Everett (Author), D. Scott, M.D. Lim (Author), Paul Burns (Illustrator), Jasper Burns (Illustrator), Marcia L. Buck (Illustrator), Jane E., M.D. Crosson (Illustrator)

The Simple Heart Cure: The 90-Day Program to Stop and Reverse Heart Disease
by Chauncey Crandall (Author)

Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, Single Volume
by Douglas P. Zipes MD (Author), Peter Libby MD PhD (Author), Robert O. Bonow MD MS (Author), Douglas L. Mann MD (Author), Gordon F. Tomaselli MD (Author)

Dr. Dean Ornish's Program for Reversing Heart Disease: The Only System Scientifically Proven to Reverse Heart Disease Without Drugs or Surgery
by Ivy Books

Moss & Adams’ Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult (2 Volume Set)
by Hugh D. Allen MD FACC FAAP FAHA (Author)

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Circular
We're told if the economy is growing, and if we keep producing, that's a good thing. But at what cost? This hour, TED speakers explore circular systems that regenerate and re-use what we already have. Guests include economist Kate Raworth, environmental activist Tristram Stuart, landscape architect Kate Orff, entrepreneur David Katz, and graphic designer Jessi Arrington.
Now Playing: Science for the People

#504 The Art of Logic
How can mathematics help us have better arguments? This week we spend the hour with "The Art of Logic in an Illogical World" author, mathematician Eugenia Cheng, as she makes her case that the logic of mathematics can combine with emotional resonance to allow us to have better debates and arguments. Along the way we learn a lot about rigorous logic using arguments you're probably having every day, while also learning a lot about our own underlying beliefs and assumptions.