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.
[Photo: Dr. Samar R. El Khoudary]
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 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 Dr. Samar R. El Khoudary, assistant professor in Pittsburgh Public Health’s Department of Epidemiology.
Dr. 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.
For more information, visit http://www.upmc.com/media/NewsReleases/2017/Pages/heart-fat.aspx. To read the JAHA publication, visit http://jaha.ahajournals.org/content/6/2/e004545.