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Clinical Investigation

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Weight changes and obesity predict impaired resting and endothelium-dependent myocardial blood flow in postmenopausal women

  1. Julie W. Martin M.D.1,
  2. Kerri Briesmiester B.S.2,
  3. Anita Bargardi ACNP2,
  4. Otto Muzik PH.D.3,
  5. Lori Mosca M.D., M.P.H., PH.D.4,
  6. Claire S. Duvernoy M.D.1,2,*

Article first published online: 5 DEC 2006

DOI: 10.1002/clc.4960280105

Issue

Clinical Cardiology

Clinical Cardiology

Volume 28, Issue 1, pages 13–18, January 2005

Additional Information

How to Cite

Martin, J. W., Briesmiester, K., Bargardi, A., Muzik, O., Mosca, L. and Duvernoy, C. S. (2005), Weight changes and obesity predict impaired resting and endothelium-dependent myocardial blood flow in postmenopausal women. Clin Cardiol, 28: 13–18. doi: 10.1002/clc.4960280105

Author Information

  1. 1

    Cardiology Division, University of Michigan, Michigan

  2. 2

    Cardiology Division, Veteran's Affairs Medical Center, Ann Arbor

  3. 3

    Department of Radiology, Wayne State University, Detroit, Michigan

  4. 4

    Cardiology Division, Columbia University, New York, New York, USA

*Assistant Professor of Medicine Division of Cardiology University of Michigan Veterans Affairs Medical Center 2215 Fuller Rd., Box 111A Ann Arbor, MI 48105-2399, USA

Publication History

  1. Issue published online: 5 DEC 2006
  2. Article first published online: 5 DEC 2006
  3. Manuscript Accepted: 20 OCT 2004
  4. Manuscript Received: 24 AUG 2004

Funded by

  • Society for Women's Health Research
  • Pfizer, Inc.
  • Veterans Affairs Ann Arbor Health System

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Keywords:

  • endothelium;
  • obesity;
  • prevention;
  • women

Abstract

Background: Obesity has been associated with impaired endothelial function, but the influence of lifetime weight patterns on endothelial function has not been studied.

Hypothesis: We hypothesized that coronary vascular reactivity would be diminished in postmenopausal women with a history of obesity and frequent weight swings.

Methods: We performed dynamic N-13 ammonia positron emission tomography in 18 postmenopausal women with cardiac risk factors. Myocardial blood flow (MBF) was measured at rest, after the cold pressor test (CPT), and after adenosine infusion in order to determine baseline and endothelium-dependent and -independent flows, respectively. Myocardial blood flow was corrected for cardiac work by normalizing to the rate-pressure product. Weight history was obtained by standardized questionnaire.

Results: Normalized rest (n-rest) MBF correlated negatively with current weight (r=-0.52, p= 0.026) and weight at age 18 (r = −0.47, p = 0.047). Normalized CPT (n-CPT) MBF correlated inversely with current weight (r = −0.55, p = 0.018), weight at age 18 (r= −0.605, p = 0.008), and highest weight (r = −0.62, p = 0.006). Higher waist circumference predicted lower n-rest MBF (r= −0.52, p = 0.028) and n-CPT MBF (r = −0.48, p = 0.04). The same association was found with hip circumference (r = −0.52, p = 0.028; r = −0.49, p = 0.038, respectively), whereas higher body mass index (BMI) predicted lower n-CPT MBF (r =-0.53, p = 0.02). Women with at least four significant weight swings had lower MBF during rest, CPT, and n-CPT (0.88 vs. 1.19 ml/g/min, p = 0.008; 0.76 vs. 1.23 ml/g/min, p< 0.001; 0.74 vs. 1.10 ml/g/ min, p = 0.009, respectively).

Conclusions: Increased waist and hip circumference, weight, and frequent weight swings are associated with impaired resting and endothelium-dependent MBF in postmenopausal women. These data suggest that lifetime weight patterns may influence cardiovascular risk in women.

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