A Fatty Heart Puts Your Health at Risk No Matter Your Weight, New Study Suggests

• Having high pericardial fat volume—fat around your heart—can increase your risk of heart failure regardless of your bodyweight, a new study suggests.
• More than 6 million people in the U.S. are impacted by heart failure, a condition in which the heart can’t pump enough blood for the body’s needs.
• To reduce the risk of excess pericardial fat, experts recommend working toward habits that contribute to better heart health overall.

Pericardial fat—the fat that surrounds your heart—may be a strong risk factor for heart failure regardless of your bodyweight, according to new research from Mount Sinai in New York.

For the study, which was published in the Journal of the American College of Cardiology, researchers used CT scans to determine the connection between pericardial fat volume and newly diagnosed heart failure, a condition in which the heart can’t pump the amount of blood the body needs to function. More than 6 million people in the U.S. have heart failure, which a person can develop suddenly or over time.

The CT scans were sourced from the Multi-Ethnic Study of Atherosclerosis sponsored by the National Heart, Lung, and Blood Institute, and included scans from 6,785 men and women between the ages of 45 and 84 without pre-existing cardiovascular disease.

The researchers found that, even though women typically had less pericardial fat than men, women who did meet the criteria for high pericardial fat volume (70 cubic centimeters or more) had double the risk of developing heart failure. Men who met the fatty heart criteria (120 cubic centimeters or more) had a 53% increased risk.

What’s more, a higher amount of pericardial fat was dangerous regardless of the participants’ body weight. That means being thin didn’t necessarily prevent harmful fat build-up around the heart.

The researchers also adjusted for other well-known risk factors for heart failure such as age, tobacco use, alcohol consumption, a sedentary lifestyle, high blood pressure, high cholesterol, and previous heart attacks. Results were similar across all racial backgrounds.

“The fat around the heart is known to be a predictor of heart disease, largely because it can be associated with other risk factors like obesity, diabetes, and high blood pressure,” explains Eugenia Gianos, M.D., associate professor of cardiology at the Zucker School of Medicine who was not involved in the study. “The fact that this association held true even after accounting for all these factors indicates that the fat may have a direct effect on the heart muscle that contributes to the abnormalities associated with heart failure.”

When there is extra fat surrounding your heart, fatty droplets may begin to accumulate within the heart muscle cells, says lead study author Satish Kenchaiah, M.D., associate professor of medicine and cardiology specialist at the Icahn School of Medicine at Mount Sinai. These droplets can interfere with how your heart chamber expands and reduce your heart’s ability to pump blood properly, setting the stage for heart failure, he says.

A fatty heart is also related to plaque buildup in the coronary arteries that supply blood to the heart muscles. This is a known risk factor for heart attacks, which could subsequently increase the risk of developing heart failure down the line, he adds.

Dr. Kenchaiah says more research is needed to determine how to reduce and prevent excess pericardial fat, but working toward habits that contribute to better heart health overall is a good place to start. To keep your ticker in tip-top shape, he recommends the following:

• Eat a Mediterranean-style diet, which is rich in colorful fruits and vegetables, fiber-rich whole grains and legumes, olive oil, nuts and seeds, and lean proteins like seafood and poultry.
• Aim for 75 minutes of heart-pumping exercise (such as running) or 150 minutes of moderate activity (like brisk walking) throughout the week.
• Avoid excessive alcohol intake, which is considered no more than one drink per day for women and two for men.
• Work with your doctor to lower high blood pressure, high blood sugar, or high cholesterol levels—all of which increase your risk of heart disease.