NEW YORK, Sep 09 (Reuters Health) -- A new type of imaging scan can help doctors identify heart problems in seemingly healthy middle-aged women.
Using electron beam computed tomography -- ultrafast CT -- to evaluate the heart in middle-aged women, may permit early detection of heart disease, Pennsylvania researchers report in the September issue of the journal Arteriosclerosis.
According to Dr. Lewis Kuller of the University of Pittsburgh and colleagues, electron beam computed tomography (EBCT) is one of several "important new approaches to study the relationship of risk factors and cardiovascular disease." Specifically, EBCT allows investigators to determine the degree of coronary artery calcification present in a given individual. Such calcifications are believed to indicate an increased risk of cardiovascular disease.
In the current research, nearly 170 out of a total of 541 women participating in the long-term Healthy Women Study, underwent EBCT. The results were correlated with measurements of cholesterol, triglycerides, physical activity, blood pressure, and other heart risk factors obtained at the beginning of the study, on average more than a decade earlier. The women, all initially premenopausal, were followed at regular intervals over subsequent years to confirm the onset of menopause and were offered EBCT when they had reached 8 years post menopause.
The investigators found a "very strong relationship between (LDL cholesterol) and coronary calcium (levels)." That is, women who had had high baseline levels of LDL cholesterol generally developed a significant degree of coronary artery calcification.
Similarly, women who had low levels of HDL ('good') cholesterol "had a much higher prevalence of coronary calcification," the investigators explain, while high levels of HDL cholesterol appeared to confer a measure of protection against calcification in coronary arteries or the aorta.
Other premenopausal factors that correlate with eventual calcification include smoking and triglyceride levels. "There was about a 3-fold higher prevalence of (coronary calcification) among cigarette smokers as compared to non-cigarette smokers," the authors point out. And, they note, "there was a significant association between... blood triglyceride levels and both aortic and coronary calcification."
That women with significant risk factors premenopausally were found to have calcifications later in life was not an unexpected outcome, according to Kuller, the study's principal investigator. "We were surprised (however) to find that the test also showed (non-symptomatic) disease in some women who had no risk factors premenopausally," he commented in a University of Pittsburgh statement.
Kuller explained the significance of this finding: "With (EBCT), we can now (detect) arterial problems much earlier in women so that they can take the necessary steps to avoid life-threatening complications later on."
