NHLBI Research Highlights at American Heart Associationís
Findings on Women and Heart Disease, Metabolic Syndrome in African Americans,
Impact of Sodium Reduction on Risk of Cardiovascular Disease or Death
At this yearís American Heart Associationís 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
Note that NHLBI will be issuing a separate release on a late breaking clinical
trial presentation on November 15 on ďThe Effects of Carbohydrate, Protein, and
Fat Intake on Cardiovascular Risk Factors: Main Results from the OmniHeart Feeding
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 Womenís 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, Womenís 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 participantís 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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