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.
NHLBI is part of the National Institutes of Health
(NIH), the Federal Government’s primary agency
for biomedical and behavioral research. NIH is a component
of the U.S. Department of Health and Human Services.
NHLBI press releases and fact sheets can be found
online at www.nhlbi.nih.gov
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