Health In Focus
  • Postmenopausal women are at high risk for heart disease due to a greater volume of a type of fat that surrounds the heart.
  • The two types of fat that surround the heart are epicardial fat and paracardial fat.
  • Paracardial fat, found outside the pericardium increases the risk of heart disease in postmenopausal women.

The risk of heart disease increases with age, but for women, especially postmenopausal women, the risk for heart disease is linked to a greater volume of a type of fat that surrounds the heart, finds a study led by a research team at the University of Pittsburgh Graduate School of Public Health. The risk of heart disease also increases with lower levels of estrogen in postmenopausal women.
Heart Fat Associated With Higher Risk of Heart Disease in Postmenopausal Women

Link Between Menopause and Heart Disease

Menopause is not directly linked to heart disease. However, some factors that contribute to heart disease increase during the time of menopause. Estrogen is known to have a positive effect on the inner layer of the artery wall and help to keep the blood vessels flexible. A decline in the estrogen hormone is a risk factor for heart disease among postmenopausal women.

The findings of the current study reveal a new menopause-specific indicator of heart disease risk, which could be a new strategy to reduce the risk of heart disease and also a target for studies on the impact of hormone replacement therapy in improving cardiovascular health.

"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.

Fat that Surround the Heart

Two types of fat that surround the heart -
  • Epicardial fat
  • Paracardial fat
Epicardial Fat is the energy source for the heart. It covers the heart tissue and is located between the outside of the heart and the pericardium (a membrane that encases the heart).

Paracardial Fat is located outside the pericardium. There are no heart-protective functions of this fat.

The study published in the Journal of the American Heart Association has identified a type of fat called 'Paracardial fat' covering the heart tissue which increases the risk of heart disease.

The research team evaluated the blood samples and heart CT scans of 478 women from Pittsburgh and Chicago. The participants had enrolled in the Study of Women's Health Across the Nation (SWAN). They were in varying stages of menopause, averaged 51-years-old and were not on hormone replacement therapy.

An earlier study conducted by the research team, showed that a greater volume of paracardial fat was linked to a decline in the sex hormone estradiol (the most potent estrogen) after midlife. However, the higher volume of epicardial fat was linked to obesity.

In the current study, the findings showed that greater paracardial fat volume was not only linked to lower levels of estradiol, but it is also associated with a greater risk of coronary artery calcification, which is an early sign of heart disease.

Among the study participants, 60% (25th percentile to the 75th percentile) increase in paracardial fat was associated with a 45% increase in the risk of coronary artery calcification in postmenopausal women compared with pre and 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.

The volumes of heart fat can be reduced with a heart healthy diet or bariatric surgery. The research team plans to conduct a study on the impact of hormone replacement therapy and its impact on heart fat accumulation with particular attention to the types of heart fat.

Heart-Healthy Diet

A healthy diet combined with regular exercise is important for keeping the heart healthy. Studies have shown that healthy lifestyle choices and a heart-healthy diet can reduce the risk of heart disease and stroke by 80%. Healthier food choices help lower the cholesterol level and normalize blood pressure, which are the risk factors for heart disease.

Tips for a Heart-Healthy Diet

Foods to Include
  • Include fiber-rich foods like whole grains, cereals, and legumes
  • Eat healthy fats such as olive oil, fish oil, nuts and seeds
  • Eat plenty of fruits and vegetables
  • Include high-quality protein - fish, lean meat and poultry
  • Choose skimmed milk and yogurt
Foods to Avoid
  • Avoid packaged foods that are high in salt and sugar (chips, fruit juices)
  • Do not consume processed meat such as bacon, sausage, and salami
  • Avoid convenience foods (cake or pancake mix)
References :
  1. Samar R. El Khoudary, Kelly J. Shields, Imke Janssen, Matthew J. Budoff, Susan A. Everson Rose, Lynda H. Powell, Karen A. Matthews. Postmenopausal Women With Greater Paracardial Fat Have More Coronary Artery Calcification Than Premenopausal Women: The Study of Women's Health Across the Nation (SWAN) Cardiovascular Fat Ancillary Study. JAHA, January 2017 DOI: 10.1161/JAHA.116.004545
  2. Menopause and Heart Disease - (
Source: Medindia

Most Popular on Medindia