The senior author of the study, Samar El Khoudary, explains how it’s time for the healthcare industry to shift gears when thinking about heart disease risk in women. This is especially important as they approach and go through menopause. El Khoudary and her team set out to determine how it isn’t how much fat a woman is carrying, but rather where the fat is being carried.
For the study, researchers looked at data on 362 women from Pittsburgh and Chicago who participated in the Study of Women’s Health Across the Nation (SWAN) Heart study. On average, all participants were aged 51 years old when they had their visceral adipose tissue (fat surrounding the abdominal organs) measured by CT scan. The thickness of the internal carotid artery lining in their neck was also measured by ultrasound at a few points during the study.
Carotid artery thickness has been found to be an early indicator of heart disease.
It was found that for every 20% increase in abdominal fat, the thickness of the carotid artery lining grew by 2% independent of overall weight, BMI, and other various risk factors linked to heart disease. Abdominal fat also had a steep acceleration, on average, within two years before the participants’ last period and continued a more gradual growth after the menopausal transition.
It is widely known that the fat that surrounds the abdominal organs is related to a larger secretion of toxic molecules that can be harmful to cardiovascular health.
Saad Samargandy, Ph.D., M.P.H., explains, “Almost 70% of post-menopausal women have central obesity — or excessive weight in their mid-section. Our analysis showed an accelerated increase of visceral abdominal fat during the menopausal transition of 8% per year, independent of chronological aging.”
Exposure to Radiation
Historically, there has been a disproportionate emphasis on cardiovascular disease and BMI and weight. The conventional way of measuring abdominal fat by CT scan is expensive and could expose women to unnecessary radiation. By regularly measuring and tracking waist circumference, physicians could monitor for accelerating increases in abdominal fat.
El Khoudary and her team had previously published a new scientific statement for the American Heart Association that calls for increased awareness of cardiovascular changes that are unique to the menopausal transition. She believes that with early lifestyle interventions, the risk for some cardiovascular events may be reduced.
However, she does warn that more research is needed to determine if certain diet, exercise, or lifestyle interventions are more effective than others. The study was not able to determine if there is a clear cut-off point for when growth in waist circumference becomes concerning for heart disease risk.