The Fattier Your Heart, the Greater Your Heart Disease Risk  

A new study suggests that the amount of hidden fat that collects around the heart--as opposed to the waist or hips--may be a stronger indicator of cardiac disease risk.

Heart fat hidden behind the rib cage -- known as pericardial fat -- is associated with irregular plaque build-up along the heart's artery walls which in turn often causes atherosclerosis and can trigger heart attacks.

This appears to occur in people with and without coronary symptoms and is insidious in that it is hidden--i.e. you can't identify it by looking at someone directly as you could a bulging waistline. 

This was a big study sponsored by the National Institute of Health which spanned many countries.  The three main findings are: 

• In people without symptoms of coronary artery disease, the pericardial fat volume is closely associated with the heart artery-clogging plaque found on the MRIs. 
• This pericardial fat seems to be more strongly related to coronary artery plaque buildup than is body mass index (or BMI, a measure of obesity) or even waist circumference. 
• Examining coronary artery walls through MRIs and CT heart fat scans may be useful in assessing the risk of heart disease. 

While MRI was used as the "gold standard" for NIH research on fat distribution and the dangers of obesity, it isn't necessary in typical patient screening for cardiac risk.  

CT scans are one of the fastest growing medical procedures in the country and may increasingly be used to evaluate coronary artery disease. Scanning often provides data on calcium in the heart vessel, and can calculate a 'fat score' index for tissues around the heart.  It is also less expensive than an MRI. 

This research suggests that doctors should be looking at the pericardial fat level as a truer measure of plaque build up in the vessels of the heart.  

The U.S. Centers for Disease Control and Prevention has declared obesity a national epidemic and a major contributor to the leading causes of death in the United States, including heart disease. Slightly more than one adult in three is obese, and one child in six is obese, the CDC reports. 

However, researches once again won't go "all-in" with their findings, indicating that their research is really to enhance new knowledge and information, not to be a risk predictor or screening tool for the general population. 

So, why fund it in the first place, and why promote your findings if you (the researchers) are going to stop short of saying, 'hey, this may really work--let's try it out'?

At the end of the day, all we can say is, get obesity under control.