How obesity and sex affect heart attack recovery

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In the UK, over 100,000 people each year are hospitalised with a heart attack; equal to one every 5 minutes. Thanks to advancements in treatments, most of these patients survive the initial heart attack, but recovery often involves complications, including developing heart failure, kidney failure, or experiencing another heart attack. While heart attacks occur more commonly in males, females have historically had worse outcomes following a heart attack. This is thought to be due to longstanding differences in care with data showing that females are 50% more likely to receive a wrong initial diagnosis when experiencing a heart attack and are 50% less likely to receive the recommended treatment during their recovery. Over the course of a decade, such differences have contributed towards an estimated 8000 avoidable deaths in females due to these differences in care.

Another key factor in the number of heart attacks that occur each year is obesity, which increases an individual’s overall risk of heart disease by 25%. Extra body weight places more strain on the heart, forcing it to work harder; high blood pressure and fatty deposits in the arteries also contribute to the risk of a heart attack occurring. However, it is not well understood how obesity affects an individual’s recovery following a heart attack, with recent evidence suggesting it can affect males and females differently. This is thought to be due to the layer of fat surrounding the heart, known as the pericardial adipose tissue (PCAT), which can become inflamed and enlarged; and previous research indicates that it may behave differently in males and females.

Dr Mhairi Paul and her team at the University of Edinburgh are aiming to better understand the role of obesity in heart attack recovery, how fat around the heart affects this recovery, and if there are significant differences between males and females. The researchers will make use of a specialised model to mimic a heart attack and compare how the heart recovers between males, females, obese, and healthy weight individuals. They will also analyse the genetic activity of the heart’s fat and tissue to determine what genes are responsible for the differences seen across sex and weight.

This research will be the first to directly examine how PCAT, obesity, and sex impact on heart attack recovery. These insights have the potential to highlight new treatment targets, providing the groundwork for further research into developing more precise therapies for heart attack patients. The research also seeks to address the differences in outcomes for female and obese patients, which could lead to more personalised treatment options in the future.