NHLBI Research Highlights at American Heart Association’s Scientific Sessions:
Findings on Women and Heart Disease, Metabolic Syndrome in African Americans, Impact of Sodium Reduction on Risk of Cardiovascular Disease or Death

At this year’s American Heart Association’s Scientific Sessions in Dallas, scientists supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health will present the latest research findings, including studies on women and heart disease, the extent of metabolic syndrome among African Americans in the Jackson Heart Study, and the impact of sodium reduction on the risk of cardiovascular disease.

Note that NHLBI will be issuing a separate release on a late breaking clinical trial presentation on November 15 on “The Effects of Carbohydrate, Protein, and Fat Intake on Cardiovascular Risk Factors: Main Results from the OmniHeart Feeding Study.”

News stories are embargoed until papers are presented or a news conference or poster session begins. To reach NHLBI spokespeople, call the NHLBI Communications Office at 301-496-4236.

• Postmenopausal women with higher levels of male sex hormones levels have greater prevalence of coronary artery disease. (Embargoed until 4:45 p.m. Central Time (5:45 p.m. ET), Tuesday, November 15) The relationship between male sex hormones called androgens and atherosclerosis in women is poorly understood. Some studies have found an increased risk of coronary artery disease in women who have high levels of androgen, such as those who have polycystic ovary syndrome. Scientists with the Women’s Ischemia Syndrome Evaluation (WISE) study analyzed blood hormone levels of 400 women (296 postmenopausal and 104 premenopausal) undergoing coronary angiography for suspected myocardial ischemia, a heart condition characterized by reduced blood flow. Hormones measured included estradiol, estrone, FSH, LH, free testosterone, sex-hormone binding globulin, androstenedione, and DHEA-S. Glucose and insulin were also measured. The investigators found that among postmenopausal women, higher levels of free testosterone and androstenedione are associated with greater coronary artery disease as shown in angiography. These associations are independent of cardiac risk factors. The scientists found no similar relationship in premenopausal women. NHLBI spokesperson: George Sopko, MD.; WISE Investigator: C. Noel Bairey Merz, Cedars Sinai Medical Center, LA. Contact Dr. Bairey Merz at Noel.BaireyMerz@cshs.org.
  
  
• Importance of socioeconomic status in predicting heart attack and cardiovascular death in women. (Embargoed until 12:00 noon Central Time (1:00 p.m. ET), Monday, November 14.) The strong relationship between socioeconomic status (SES) and cardiovascular disease is known. However, the impact of SES on heart attacks and cardiovascular death in women is complex, as women are more likely to live in poverty than men. To help clarify this complex relationship, Women’s Ischemia Syndrome Evaluation (WISE) study investigators explored the relative contributions of SES factors compared to traditional heart disease risk factors on heart attack and death in 819 women. Through exams, medical histories and records, questionnaires, and angiography, the scientists obtained extensive information on such SES factors as ethnicity, marital status, highest level of education, retirement status, income, and health insurance coverage. During the 5 years of follow-up, there were 92 deaths or heart attacks. In general, women with the following characteristics were more likely to have negative heart-related outcomes: less than a 9th grade education, being African American, Hispanic, Asian, or American Indian, on public insurance, unmarried, with annual household income less than $20,000, disabled, employed less than full time, and in service or technical jobs. An evaluation of all SES factors revealed that insurance status and income were the single greatest predictors of a participant’s cardiovascular status. When the scientists controlled for severity of coronary artery disease as shown on angiography, income remained a significant predictor of cardiovascular death and heart attack. The scientists predicted that survival without a heart attack ranged from 86 percent to 98 percent for women earning less than $20,000 to over $100,000 per year respectively. NHLBI spokesperson: George Sopko, M.D.; WISE Investigator: Leslee J. Shaw, Ph.D., Cedars Sinai Medical Center, LA. Contact Dr. Shaw at (404) 229-7339.
  
  
• More than one-third of African Americans in Jackson Heart Study have metabolic syndrome. (Embargoed until 9:30 a.m. Central Time (10:30 a.m. ET), November 13) Among the 5,296 participants in the longitudinal observational study of African Americans and heart disease, 36 percent of men and women had metabolic syndrome at the baseline visit. The prevalence increased according to the age of participants: 15. 5 percent of participants aged 20-35, 38 of those between 45-64 and 45 percent of participants 65 and older. The syndrome was more prevalent among women (40 percent) than men (29 percent). Obesity and high blood pressure were the most common indicators of metabolic syndrome in this cohort. Also, 44 percent of participants had low HDL cholesterol. It is well known that the individual risk factors of hypertension and obesity are highly prevalent among blacks, but this paper dramatically underscores how frequently they occur together, each factor compounding the risk of the other metabolic syndrome characteristics. Also surprising is the relatively high prevalence of low HDL cholesterol, since traditionally, it has been reported that African Americans have higher HDL levels than their non-African American counterparts in the US. Available spokesperson: Cheryl Nelson, NHLBI. Study investigator: Herman A. Taylor, Jr., M.D., University of Mississippi Medical Center. Contact: Jackson Heart Study at (601) 368-4650.
  
  
• Reducing dietary sodium reduces CVD risk by 26 percent. (Embargoed until 9:30 a.m. Central Time (10:30 a.m. ET), November 15) Research has shown that reducing sodium has a direct affect on lowering high blood pressure. But does this dietary intervention have a similar affect on cardiovascular disease risk? In a randomized trial of men and women ages 30-54 with prehypertension, risk of total cardiovascular disease or death was reduced by 26 percent among those who followed a reduced sodium diet. The Trials of Hypertension (TOHP) follow-up study evaluated patient outcomes 9-14 years following the dietary interventions. Scientists conclude that a higher average intake of sodium may be associated with increased risk of cardiovascular events. Available spokesperson: Jeffrey Cutler, M.D, NHLBI. Presenter: Nancy Cook, ScD, Brigham and Women's Hospital. To interview Dr. Cook, contact Lori Shanks at (617) 534-1604.

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