Health

4 out of 10 adults with no known heart disease have a fat heart

Amy Norton Health Day Reporter

Wednesday, September 22, 2021

A large new study shows that many middle-aged adults with an apparently healthy heart have “quiet” accumulation of fat deposits in their arteries.

Researchers found that out of more than 25,000 people aged 50-64, about 42% had signs. Atherosclerosis — Accumulation of “plaque” in the arteries heart attack Also stroke..

It was despite the fact that no one had history heart problem.

Experts said the percentage of “silent” was high Atherosclerosis It wasn’t surprising. Other small studies have suggested the same.

However New result — From a random sample of the Swedish population — confirm that this condition is widespread among middle-aged people.

“For a representative population, it’s a really important study,” said Dr. Donald Lloyd Jones, President of the United States. heart Association. “42 percent of people in this age group do have some plaque in their arteries, and it’s important to focus on it.”

Fortunately, atherosclerosis heart attack Also stroke:control High blood pressure,unhealthy cholesterol When Hyperglycemia,Stop smoking, And stick to health diet Regularly exercise Among them, the author of the study said.

“Working on these risk factors is very important in this age group,” said Dr. Golan Bergström, principal investigator of the study and professor at Gothenburg University in Sweden.

The findings were published online in the journal on September 20th. circulationIs based on about 25,200 Swedish adults who have no history of heart attacks or procedures to treat blocked heart arteries. All underwent two types of imaging: coronary calcium screening and CT Angiography..

During calcium screening, CT scan Because calcium is a component of plaque, it is used to detect calcium deposits in the heart arteries.

Calcium screening is now the standard test, Lloyd Jones said. If you are uncertain whether to prescribe a statin, your doctor may use it. cholesterol-Drop Drug Reduce the risk of heart attack, stroke..

This uncertainty can occur when a patient is at “moderate” risk of having a heart attack over the next decade, for example due to factors such as age or age. blood pressure — But there is LDL (“bad”) Cholesterol level It does not reach “high”.

A zero calcium score means no calcium is detected in the arteries, and these people are often considered to have a low risk of heart attack.

CT AngiographyOn the other hand, by injecting a contrast medium into the blood vessels, CT scan To find plaque.

Based on that test, Bergstrom’s team found that 42% of the study participants had some degree of atherosclerosis.

In general, these angiographic results were consistent with the study participants’ calcium scores. Of the patients with very high calcium scores, all showed evidence of atherosclerosis on CT angiography.

However, the study found that even among people with zero calcium scores, 5.5% actually suffered from some degree of atherosclerosis based on angiography.

According to Bergstrom, the findings suggest that CT angiography provides “additional information beyond coronary calcium scoring.”

“This study [CT angiography] May change clinical practice in the future, Prevention Strategy and risk management. ” But he added that more research is needed to prove it.



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Lloyd Jones looked at the findings differently.

“For me, this confirms it [calcium] The score does a great job. “

He pointed out that current treatment guidelines do not mean that patients need to be automatically skipped just because their calcium score is zero. Statins..When those people smoke or have Diabetes mellitus Or a premature strong family history Heart disease, Statins treatment is recommended.

And in this study, people with atherosclerosis despite having a zero calcium score tended to have higher risk factors for heart damage. smoking When obesity..

“I think this is a good confirmation that the guidelines were done correctly,” Lloyd Jones said.

Therefore, at this point, he said, those concerned about the risk of a future heart attack should not seek CT angiography, which is more expensive and involves more. radiation From the calcium score.

Instead, the advice is less technical. “Be with your doctor and know what your number is,” said Lloyd Jones. blood pressure, Cholesterol and blood sugar..

If your doctor hasn’t done so already, ask your doctor to calculate your 10-year risk of a heart attack (a “number” and a simple estimate based on factors such as age and gender). In some cases, Lloyd Jones said calcium screening may be recommended to clarify your risk.

From there, he said, any treatment plan, whether lifestyle-altered alone or on medication, must be “individualized.”

For more information

American Heart Association Lifestyle and heart attack prevention..

Source: Goran Bergstrom, MD, PhD, Professor, Senior Consultant, Clinical Physiology, School of Molecular Clinical Medicine, Gothenburg University, Sweden. Donald Lloyd Jones, MD, ScM, President of the American Heart Association, Dallas, and Chairman of the Preventive Medicine Division of the Feinberg School of Medicine at Northwestern University in Chicago. circulation, September 21, 2021, online

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4 out of 10 adults with no known heart disease have a fat heart

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