Obesity and Cardiovascular Risk: Systematic Intervention Is the Key for Prevention

Abstract

Obesity is a serious public health issue and associated with an increased risk of cardiovascular disease events and mortality. The risk of cardiovascular complications is directly related to excess body fat mass and ectopic fat deposition, but also other obesity-related complications such as pre-type 2 diabetes, obstructive sleep apnoea, and non-alcoholic fatty liver diseases. Body mass index and waist circumference are used to classify a patient as overweight or obese and to stratify cardiovascular risk. Physical activity and diet, despite being key points in preventing adverse events and reducing cardiovascular risk, are not always successful strategies. Pharmacological treatments for weight reduction are promising strategies, but are restricted by possible safety issues and cost. Nonetheless, these treatments are associated with improvements in cardiovascular risk factors, and studies are ongoing to better evaluate cardiovascular outcomes. Bariatric surgery is effective in reducing the incidence of death and cardiovascular events such as myocardial infarction and stroke. Cardiac rehabilitation programs in obese patients improve cardiovascular disease risk factors, quality of life, and exercise capacity. The aim of this review was to critically analyze the current role and future aspects of lifestyle changes, medical and surgical treatments, and cardiac rehabilitation in obese patients, to reduce cardiovascular disease risk and mortality, and to highlight the need for a multidisciplinary approach to improving cardiovascular outcomes.

Overweight, Obesity, and Age Are the Main Determinants of Cardiovascular Risk Aggregation in the Current Mexican Population: The FRIMEX III Study

“…The cohort comprised a non-probabilistic sample of 300,000 participants of both genders (recruited in the last 10 years). Body mass index (BMI, kg/m 2 ) was obtained in all subjects through weight and height and was classified, according to the WHO, [15] as underweight (BMI < 18.5), healthy weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), and obesity (BMI ≥ 30.0). Blood pressure (BP) was measured with calibrated mercurial sphygmomanometers following standard recommendations [22].…”

“…The last triad leads to the development of morbid conditions that affect multiple organs and systems [13]. According to the World Health Organization (WHO), obesity is classified, using the body mass index (BMI, kg/m 2 ), into the following three categories: class 1 (BMI of 30 to <35), class 2 (BMI of 35 to <40), and class 3 (BMI of 40 or higher) [14,15]. In many studies, a strong linear relationship between the degree of obesity and the occurrence of HBP, stroke, and myocardial infarction has been demonstrated [16].…”

Performance of Body Fat Percentage, Fat Mass Index and Body Mass Index for Detecting Cardiometabolic Outcomes in Brazilian Adults

“…; 5 LDL-c ≥ 160 mg/dL. 6 HDL-c < 40 mg/dL (men) and < 50 mg/dL (women). 7 C-reactive protein > 2 mg/dL.…”

“…In summary, increased overall body adiposity causes multiple cardiovascular pathological disorders, concerning electrocardiographic, hemodynamic, structural and functional changes. Such chronic alterations increase the risk of cardiovascular diseases, as well as related adverse cardiometabolic complications [6]. Moreover, obesity increases healthcare costs, reduces work productivity and quality of life and causes disability and premature death [1].…”

Interventions to Address Cardiovascular Risk in Obese Patients: Many Hands Make Light Work

“…However, BMI indicates the overall excess body weight, while waist circumference better defines fat distribution and abdominal body fat [24,25]. Additionally, BMI is inadequate for defining body composition and the difference between fat mass and fat-free distribution and abdominal body fat [24,25]. Additionally, BMI is inadequate for defining body composition and the difference between fat mass and fat-free mass; specifically, the CV risk differs according to the type of ectopic deposition [1, 24,26,27].…”