2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guid
Muscle Fat May Pose Higher Risk To Heart Health Than Other Forms Of Fat
Traditionally viewed as a disease of affluence, heart disease is now common in low and middle-income countries, being responsible for one-third of all deaths globally.
Lifestyle, and some health conditions, can increase or decrease a person's risk of developing heart disease. Factors that increase heart disease risk include:
To reduce heart disease risk, the CDC advise maintaining a healthy weight, eating a diet high in fiber and low in saturated and trans fats, getting regular physical activity, and not smoking.
A new study, from Brigham and Women's Hospital and Faculty at Harvard Medical School, Boston, has found that it may not just be having excess body fat that increases heart disease risk, but where fat is stored, even in those of a healthy weight.
The study, which appears in the European Heart Journal, found that intramuscular fat — fatty pockets within muscle tissue — increased a person's risk of serious heart disease, regardless of their body mass index (BMI).
Cheng-Han Chen, MD, a board-certified interventional cardiologist, and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, not involved in the study, told Medical News Today:
"This observational study found an association between specifically the 'intramuscular' fat and increased risk of developing heart disease. This is the first large-scale study to compare different types of fat distribution in the body (intramuscular vs. Subcutaneous) and provides insight into how we might better assess someone's health status by their fat distribution."
"Characterizing someone's fat distribution might provide more nuanced prognostic information than our current flawed 'body mass index' measurements," he added.
Researchers recruited 669 participants, with an average age of 63 years, who were being evaluated for chest pain and/or shortness of breath caused by cardiac ischemia but had no evidence of coronary artery disease, a condition called INOCA (Ischemia with No Coronary Atherosclerosis).
They tested the participants' heart function using cardiac positron emission tomography or computed tomography (PET/CT) scans. The researchers also measured the fat and muscle amounts and location in a section of the torso of each participant.
From these measurements, they calculated the "fatty muscle fraction" — the ratio of intramuscular fat to total muscle plus fat — to quantify how much fat was stored within each person's muscles.
Chen told MNT that it is hard for people to know how much intramuscular fat they have because "there is currently no widely agreed-upon test method for quantifying 'intramuscular' fat."
"This study used CT scan measurements at a certain level of the abdomen to quantify the amount of fat in relation to the muscle detected. In the future, intramuscular fat might be measured through other techniques," he explained.
Following the initial scans, participants were followed up for around 6 years, during which time researchers recorded whether they died from, or were admitted to hospital for, heart disease or heart failure.
People with more fat in their muscles were more likely to have abnormal blood flow within the smallest blood vessels that supply the heart, a condition known as coronary microvascular dysfunction (CMD). They were also at increased risk of death or hospitalization due to heart disease.
Only a small increase in fatty muscle fraction was needed to increase risk of heart disease — for every 1% increase in fatty muscle fraction, CMD risk increased by 2%, and risk of future serious heart disease by 7%.
These increases in risk were not affected by other known risk factors for heart disease, BMI, or subcutaneous fat.
Those with the highest levels of intramuscular fat, together with CMD, were at the highest risk of death, heart attack and heart failure. Those with more lean muscle had a reduced risk.
Lead author of the study, Viviany Taqueti, MD, MPH, Director of the Cardiac Stress Laboratory at Brigham and Women's Hospital and Faculty at Harvard Medical School, said in a press release that "knowing that intermuscular fat raises the risk of heart disease gives us another way to identify people who are at high risk, regardless of their body mass index."
"These findings could be particularly important for understanding the heart health effects of fat and muscle-modifying incretin-based therapies, including the new class of glucagon-like peptide-1 receptor agonists," she pointed out.
In the press release, Taqueti noted that "what we don't know yet is how we can lower the risk for people with fatty muscles."
"For example, we don't know how treatments such as new weight-loss therapies affect fat in the muscles relative to fat elsewhere in the body, lean tissue, and ultimately the heart," she said.
Studies suggest that a high-fat diet will increase muscle fat. However, Chen explained to MNT that scientists do not yet know if or how intramuscular fat can be specifically reduced.
He advised that reducing total body fat will benefit health.
"In order to reduce total body fat, we advise patients to exercise regularly (both cardio and weight training) and eat a healthy diet higher in fiber and protein and lower in saturated fat and carbohydrates," he told us.
Taqueti and her team are now following up this research by assessing the impact of treatment strategies including exercise, nutrition, weight-loss drugs or surgery, on body composition and metabolic heart disease.
These Three Heart Problems Strongly Increase Dementia Risk
Three common heart conditions—heart failure, atrial fibrillation, and coronary heart disease—are closely linked to cognitive decline and a higher risk of dementia, according to a new scientific statement from the American Heart Association, published in Stroke.
The statement reviews the latest evidence on how heart health and brain health are interconnected, emphasizing the importance of managing cardiovascular health to protect cognitive function.
Dr. Fernando D. Testai, a neurologist and stroke expert from the University of Illinois, highlights the significance of this relationship. "Stroke and cognitive decline are chronic, disabling conditions with wide-ranging impacts.
Managing heart health early in life can help prevent cardiovascular issues, protect brain health, and reduce the risk of dementia," he explained.
While dementia is often seen as inevitable, research shows that adopting a healthy lifestyle and addressing vascular risk factors early may help preserve brain function and reduce the burden of diseases like Alzheimer's.
Heart Failure and Cognitive Decline
Heart failure is a widespread condition caused by issues like high blood pressure, obesity, and Type 2 diabetes.
It significantly affects cognitive abilities such as memory and decision-making, with nearly half of people with heart failure experiencing some degree of cognitive impairment. The severity of cognitive decline often correlates with the severity of heart failure.
The condition affects the brain in several ways. Reduced blood flow can lead to small, silent strokes and brain injuries. Chronic inflammation and hormonal imbalances further damage brain tissues.
Conditions like obesity and sleep disorders, common in heart failure patients, also contribute to cognitive issues. Brain scans of heart failure patients often reveal reduced gray matter and white matter damage, which impair brain function.
Patients with severe heart failure are advised to undergo cognitive screening before undergoing major treatments, as they are at higher risk of strokes, a key driver of cognitive decline.
Atrial Fibrillation and the Brain
Atrial fibrillation, a common irregular heart rhythm, affects millions of adults and is expected to become more prevalent in the coming decades.
It is strongly linked to strokes, which are a leading cause of cognitive decline. People with atrial fibrillation are 39% more likely to experience cognitive impairment, even without suffering a major stroke.
Shared risk factors, including high blood pressure, diabetes, and smoking, contribute to both atrial fibrillation and dementia.
Reduced blood flow, microbleeds in the brain, and systemic inflammation are among the mechanisms linking the two conditions. Inflammation can increase the risk of blood clots and brain injury, further impacting cognitive health.
Treating atrial fibrillation through medications, procedures like catheter ablation, or anti-clotting therapies may help reduce the risk of cognitive decline. Researchers are exploring whether restoring a normal heart rhythm can have greater benefits for brain health than medication alone.
Coronary Heart Disease and Dementia Risk
Coronary heart disease, caused by the narrowing of blood vessels that supply the heart, is another major risk factor for dementia. Studies involving over a million participants show that heart disease increases the likelihood of developing dementia by 27%.
After a heart attack, as many as half of patients experience cognitive challenges, including memory problems and difficulties with planning and decision-making.
Heart disease harms the brain by reducing blood flow, causing inflammation, and damaging small blood vessels in the brain.
These effects overlap with those seen in Alzheimer's disease, highlighting the close connection between vascular health and brain health. Genetic factors that predispose individuals to heart disease may also contribute to brain shrinkage and cognitive decline.
While more research is needed to fully understand these links, managing vascular risk factors like high blood pressure and diabetes may help protect cognitive health.
Lifestyle changes, including a healthy diet and regular exercise, can also play a significant role in reducing the risk of both heart disease and dementia.
Prevention Is Key
The findings reinforce the idea that prevention is better than cure. While new treatments for Alzheimer's are being developed, improving heart health earlier in life remains one of the best ways to protect brain function.
Dr. Testai stresses the importance of a holistic approach to health, promoting healthy habits and monitoring cardiovascular risk factors throughout life.
Additionally, more research is needed to understand how factors like gender, race, and ethnicity affect the heart-brain connection. By focusing on heart health, individuals can take meaningful steps to reduce the risk of cognitive decline and maintain overall well-being as they age.
If you care about heart disease, please read studies that herbal supplements could harm your heart rhythm, and how eating eggs can help reduce heart disease risk.
For more health information, please see recent studies that apple juice could benefit your heart health, and results showing yogurt may help lower the death risks in heart disease.
The research findings can be found in Stroke.
Copyright © 2025 Knowridge Science Report. All rights reserved.
Find Out If Your Heart Is Healthy: Expert Lists Signs You Are Not At A Risk Of Heart Disease
1. You do not SmokeSmoking increases the risk of heart disease by two times and four times the risk of early onset stroke: cardiac and cerebral. It also increases blood pressure levels, heart rate, atherosclerosis, and thrombosis, which leads to blockage and clot formation in the arteries. According to the American Heart Association (AHA), quitting smoking can cut off your heart disease by half. Also, it can reduce the risk of death and heart attacks by heart diseases by 50%.
2. You have a Healthy WeightObesity may increase blood pressure and blood sugar levels and increased cholesterol levels which further leads to an increased risk of cardiac events. According to the World Health Organization (WHO), being obese means having a Body Mass Index (BMI) greater than or equal to 30.
3. You do not have High Blood Sugar LevelsWhen the body cannot produce or efficiently use insulin, it results in increased blood sugar levels. "People with Diabetes (PwD) have the risk of diabetic cardiomyopathy and Coronary Artery Disease (CAD), which are severe complications of diabetes and leading causes of heart failure in diabetes patients, "said Dr Jhamb. Blood sugar levels for adults should be between 80 and 130 mg/dL before eating and less than 180 mg/dL two hours after eating.
4. You Have A Healthy Blood PressureHigh blood pressure (hypertension) is a serious medical condition which can significantly increase the risk of heart and brain strokes, kidney and other diseases. Start by checking your blood pressure levels if you suspect a problem. If your blood pressure falls within the normal range, you should continue following heart-healthy habits like exercising and maintaining a balanced diet. If you have blood pressure readings below 120/80 mmHg, consider it normal. However, if the blood pressure rises, it is important to consult with your doctor to avoid complications.
5. Your Cholesterol Levels are NormalCholesterol levels play an important role in predicting your heart health. "This means keeping Low-Density Lipoprotein (LDL), or 'bad' cholesterol, low and High-Density Lipoprotein (HDL), or 'good' cholesterol, high. When LDL and triglyceride levels are high, and HDL levels are low, fatty deposits can build up in the arteries, restricting blood flow and increasing the risk of heart attack," explained Dr Jhamb.
6. You are Physically ActiveRegular physical activity, such as walking, running or swimming can significantly help lower your risk of a heart attack. On the other hand, a sedentary lifestyle or little to no movement can put you at risk of obesity and heart disease.
7. You have A Healthy DietEating a balanced diet rich in fruits, vegetables, whole grains and lean proteins can help lower your risk of heart disease and can also help you keep your weight in check. According to a 2023 study, the most effective heart-healthy diets are the Mediterranean, DASH, and plant-based diets. These diets prioritise fruits, vegetables, nuts, legumes, and whole grains.
8. You Manage Stress EffectivelyYou may be at greater risk of heart disease if you suffer from chronic stress. According to the University of Rochester Medical Center (URMC), high levels of cortisol (stress-producing hormone) can raise your cholesterol, blood sugar, and blood pressure levels. Hence, practising stress-reducing techniques like meditation, yoga or deep breathing exercises can help mitigate this risk.
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]
Comments
Post a Comment