Tuesday, January 21, 2020
Belly fat linked with repeat heart attacks
Heart attack survivors who carry
excess fat around their waist are at increased risk of another heart attack,
according to research published today in the European Journal of Preventive Cardiology,
a journal of the European Society of Cardiology (ESC).1
Prior studies
have shown that abdominal obesity is an important risk factor for having a
first heart attack. But until now, the association between abdominal obesity
and the risk of a subsequent heart attack or stroke was unknown.
“Patients are
typically put on a stringent medical treatment regimen after their first attack
to prevent second events (called secondary prevention),” said study author Dr.
Hanieh Mohammadi of the Karolinska Institute, Stockholm, Sweden. “Secondary
prevention works through reducing risk factors associated with heart attack and
stroke such as high blood sugar, lipids and blood pressure. It was previously
unknown whether abdominal obesity is a risk factor for recurrent events among
patients on secondary prevention treatments.”
The study, the
largest and most definitive ever conducted on this topic, followed more than
22,000 patients after their first heart attack and investigated the relation
between abdominal obesity (measured by waist circumference) and the risk for
recurrent cardiovascular disease events. The researchers specifically looked at
events caused by clogged arteries, such as fatal and non-fatal heart attack and
stroke. Patients were recruited from the nationwide SWEDEHEART registry and
followed for a median of 3.8 years.
Most patients –
78% of men and 90% of women – had abdominal obesity (waist circumference 94 cm
or above for men and 80 cm or above for women).
Increasing
abdominal obesity was independently associated with fatal and non-fatal heart
attacks and strokes, regardless of other risk factors (such as smoking,
diabetes, hypertension, blood pressure, blood lipids and body mass index [BMI])
and secondary prevention treatments. Waist circumference was a more important
marker of recurrent events than overall obesity.
Dr. Mohammadi
said: “The reason abdominal obesity is very common in patients with a first
heart attack is that it is closely linked with conditions that accelerate the
clogging of arteries through atherosclerosis. These conditions include
increased blood pressure, high blood sugar and insulin resistance (diabetes) as
well as raised blood lipid levels.”
“Our results,
however, suggest that there may be other negative mechanisms associated with
abdominal obesity that are independent of these risk factors and remain
unrecognised,” she added. “In our study, patients with increasing levels of
abdominal obesity still had a raised risk for recurrent events despite being on
therapies that lower traditional risk factors connected with abdominal obesity
– such as anti-hypertensives, diabetes medication and lipid lowering drugs.”
This was the
first study of its kind to analyse men and women together and separately. The
relationship between waist circumference and recurrent events was stronger and
more linear in men. In women the relationship was U-shaped, meaning that the
mid-range waist circumference (rather than the lowest) was the least risky. It
must be noted that the mid-range waist circumference for women included in the
study was above the cut-off traditionally recognised for abdominal obesity (80
cm).
Dr. Mohammadi
noted: “There were three times as many men in the study compared to women,
contributing to less statistical power in the female group. Therefore, more
studies are needed before definite conclusions can be drawn according to
gender, but this is a start.”
Regarding
possible reasons for the different results between sexes, she said: “Some
studies have suggested that abdominal obesity may be more directly associated
with the evil visceral fat (fat that sits around your organs) in men compared
to women. In women it is thought that a greater portion of the abdominal fat is
constituted by subcutaneous fat which is relatively harmless.”
Dr. Mohammadi
concluded: “Abdominal obesity not only increases your risk for a first heart
attack or stroke, but also the risk for recurrent events after the first
misfortune. Maintaining a healthy waist circumference is important for
preventing future heart attacks and strokes regardless of how many drugs you
may be taking or how healthy your blood tests are. Abdominal obesity can be
tackled by eating a healthy and balanced diet and regular physical activity.”
The authors recommend
using waist circumference in clinical settings to identify first-time heart
attack patients at increased risk of recurrent events.
Journal article: https://journals.sagepub.com/doi/10.1177/2047487319898019
Source: https://myfusimotors.com/2020/01/21/belly-fat-linked-with-repeat-heart-attacks/
Subscribe to:
Posts (Atom)