News Release

Non-Invasive Techniques To Visualize Heart Disease Confirm Importance Of Pre-Menopausal Risk Factors, Find U. Of Pgh. Researchers

Peer-Reviewed Publication

University of Pittsburgh Medical Center

PITTSBURGH, March 26 -- Using electron beam computed tomography (EBCT) to visualize early heart disease, a University of Pittsburgh team has found that pre-menopausal risk factors strongly predict which women will develop coronary artery disease five to eight years after menopause.

The study is the first to combine EBCT scans of the aorta and coronary arteries with carotid ultrasounds to assess the extent of heart disease in living people, according to Kim Sutton-Tyrrell, Ph.D., associate professor of epidemiology at the University's Graduate School of Public Health. The report is being presented March 26 at the Conference on Cardiovascular Disease Epidemiology and Prevention in Orlando, Fla.

"The important news for pre-menopausal women is that risk factors such as smoking and increased levels of bad, or low density, cholesterol, strongly predict whether they will develop heart disease after menopause," said Dr. Sutton-Tyrrell. "It's very likely that young, pre-menopausal women who modify these factors will decrease later development of heart disease."

The study, involving 219 women in their late 50s and early 60s, found that measurements of vascular disease in carotid arteries, or in the aorta, strongly correlated with the extent of disease in coronary arteries.

"We are excited about our findings for the management of post-menopausal women because we know that vascular disease generally appears in the aorta and the carotid artery before it appears in the heart," added Dr. Sutton-Tyrrell. "By detecting early vascular disease in the aorta or carotids, we may be able to predict who is at risk for coronary artery disease. By modifying risk factors in these women, we may be able to delay the development of heart disease or prevent it altogether in post-menopausal women. These steps could significantly decrease the incidence of heart attacks in this population. We hope to study these women for as long as possible so we can further explore these emerging results."

EBCT is an ultra-fast computed tomography scanner that non-invasively can take 30 pictures of the heart in the time it takes to hold one deep breath. EBCT measures the extent of calcification inside blood vessels. Sonar-like ultrasound employs sound waves to measure the thickness of blood vessel walls and identify areas where plaque has deposited. Using both techniques, doctors can spot arterial plaque build-up long before life-threatening obstructions occur.

Dr. Sutton-Tyrrell's team also found that higher pre-menopausal blood pressure was a strong predictor of post-menopausal heart disease only in women taking hormone replacement therapy (HRT), which combines the hormones progesterone and estrogen. High blood pressure did not predict heart disease in women not on HRT.

"These findings may help explain why the large-scale Heart and Estrogen/Progesterone Replacement Study recently failed to find a benefit of HRT for women with pre-existing heart disease," added Dr. Sutton-Tyrrell. "We know that estrogen protects against heart disease, but it is possible that these benefits are off-set by adverse effects of progesterone on blood pressure."

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