- 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.
Link Between Menopause
and Heart Disease
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.
‘Higher volume of a type of fat that surrounds the heart called as ‘paracardial fat’ increases the risk of heart disease and lowers hormone levels in 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.
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.
Surround the Heart
Two types of fat
that surround the heart -
- Epicardial fat
- Paracardial 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).
is located outside the pericardium. There are
no heart-protective functions of this fat.
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.
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
, 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
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
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.
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
- 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
- Include high-quality protein -
fish, lean meat and poultry
- Choose skimmed milk and yogurt
- 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
- 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
- Menopause and Heart Disease - (http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Menopause-and-Heart-Disease_UCM_448432_Article.jsp)