Obesity and Coronary Artery Disease

Abstract

The impact of obesity can be beter understood by studying the growing medical and socioeconomic burden of this often neglected public health epidemic. Traditionally associated with cardiovascular risk factors like hypertension, hyperlipidemia, and diabetes mellitus, morbid obesity has increasingly contributed to mortality among Western as well as Third World populations. Contemporary evidence has also consistently linked this patient cohort with a greater risk to develop coronary artery disease. Recent population-based registries indicate that 43 and 24% of all cases of coronary revascularization were performed in overweight and obese patients, respectively. In this context, although popular thought has reairmed the positive correlation between obesity and increased cardiovascular morbidity, some authors have opined a beter clinical outcome in overweight and obese patients, a phenomenon they termed "obesity paradoxon." Conlicting data and the possibility of confounding bias have festered an ongoing debate challenging this "obesity paradox." In this review article, we present updated evidence and discuss the validity of the "obesity paradoxon" in a variety of clinical setings.