Check the Neck for Heart Risk

March 12, 2009— -- When a doctor determines your risk for heart disease, he or she might look at your weight, cholesterol level and blood pressure. But soon, they may also look at your neck.

Independent of other factors, the width of your neck may play a role in determining your heart disease risk, according to researchers with the National Heart, Lung and Blood Institute's Framingham Heart Study, who presented their data Wednesday at a meeting of the American Heart Association in Orlando, Fla.

"It's very interesting that neck circumference was associated with [higher measures of] heart disease risk," said Dr. Vijay Nambi, a cardiologist at the Baylor College of Medicine, who was not involved with the research.

He noted that if the results of the preliminary research hold up after further study, it could provide a novel approach in determining a patient's risk.

"We normally end up struggling with trying to find out what are the best measures of obesity and fat?" said Nambi.

Since this is the first presentation of the data, Sarah Rosner Preis, a postdoctoral fellow with NHLBI and the study's lead author, noted that the findings are preliminary. Her findings were that a wider neck was associated with riskier levels of other measurements for heart disease -- such as higher systolic blood pressure and lower "good" HDL cholesterol -- but not heart disease itself.

Still, the connection could be an important one if the finding is borne out in future research. And if true, heart disease would join a list of other diseases linked to a thicker neck.

"To our knowledge, there has been no study that has specifically examined the association between neck circumference and risk of heart disease," she said. "Prior studies have suggested that neck circumference may be associated with diabetes, insulin resistance and hypertension."

New Measurement for Heart Disease

Neck measurement as a sign of heart disease risk would be easier to look at than visceral adipose tissue, or VAT -- the type of deep-lying fat that surrounds organs in the abdomen, Nambi says.

"It's an easy enough measurement, it doesn't cost anything. It just takes a minute or so to measure it," he said. Levels of VAT, on the other hand, can only be determined with a CT scan.

But even if a thicker neck turns out to be a sign of an at-risk heart, Nambi said, that might not mean that measuring your neck alone will ever be a conclusive test that lets a doctor determine heart disease risk.

He noted that even now, there is some correlation between waist-to-hip ratio and obesity and heart disease, but cholesterol level and blood pressure remain the measurements of choice in determining heart risk. The reason is that there are numeric goals for cholesterol and blood pressure, but there is not as simple a numeric target for weight loss.

Similarly, he noted, more research would be needed to determine how the circumference of the neck affects heart disease risk in order for the measurement to become useful in the clinic.

Ultimately, said Nambi, research is needed to determine whether the neck fat causes heart disease or if it is just a sign of risks caused by something else.

And ultimately, obsessing about your collar size may not be the key to a healthy heart.

"When you lose weight from one source, you're going to lose fat all over your body," he said. "Having a healthy lifestyle, several studies have shown that's the best you can do to improve your [heart health] profile."