Obesity Paradox in Patients with Hypertension and Coronary Artery Disease

Uretsky, Seth; Messerli, Franz H.; Bangalore, Sripal; Champion, Annette; Cooper‐DeHoff, Rhonda M.; Zhou, Qian; Pepine, Carl J.

doi:10.1016/j.amjmed.2007.05.011

Cited by 475 publications

(360 citation statements)

References 35 publications

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“…These findings were supported by a large meta‐analysis that showed HF patients who were overweight or obese had a significant reduction in all‐cause and cardiovascular mortality 6. The obesity paradox has been reported in other CVD conditions such as hypertension, CAD, and atrial fibrillation 7, 8. This paper reviews the effects that obesity has on cardiovascular function, including the risk of developing and prognosis of HF.…”

Section: Introductionmentioning

confidence: 68%

Obesity paradox in heart failure: a heavy matter

et al. 2016

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Obesity and heart failure are two of the leading causes of morbidity and mortality in the world. The relationship between obesity and cardiovascular diseases is complex and not fully understood. While the risk of developing heart failure has been shown to be higher in patients who are obese, there is a survival advantage for obese and overweight patients compared with normal weight or low weight patients. This phenomenon was first described by Horwich et al. and was subsequently confirmed in other large trials. The advantage exists irrespective of the type, aetiology, or stage of heart failure. Patients with morbid obesity (body mass index >40 kg/m2), however, do not have the same survival advantage of their obese counterparts. There are several alternative indices of obesity available that may be more accurate than body mass index. The role of weight loss in patients with heart failure is unclear; thus, providing sound clinical advice to patients remains difficult. Future prospective trials designed to evaluate the link between obesity and heart failure will help us understand more fully this complex relationship.

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Section: Introductionmentioning

confidence: 68%

Obesity paradox in heart failure: a heavy matter

et al. 2016

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“…Concomitant comorbidities in these subgroups may, in part, account for the attenuation of the effect of abdominal obesity on incident AF from these factors in the present study. Previous studies have observed that overweight status, obesity, and high WC may be associated with favorable prognosis—referred to as the “obesity paradox”—in patients with cardiovascular disease 43, 44, 45, 46, 47. In populations with severe comorbidities (heart failure, renal disease), obesity may also have protective effects against AF (the obesity paradox).…”

Section: Discussionmentioning

confidence: 99%

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Baek

Yang

Kim

et al. 2017

JAHA

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BackgroundHigher height and weight are known to be associated with higher risk of atrial fibrillation (AF); however, whether the risk of AF is related to abdominal obesity is unclear.Methods and ResultsWe studied 501 690 adults (mean age: 47.6±14.3 years; 250 664 women [50.0%]) without baseline AF in the National Sample Cohort released by the National Health Insurance Service in Korea. Body mass index (underweight defined as <18.5; normal, 18.5 to <25.0; overweight, 25.0 to <30.0; and obese, ≥30.0) and waist circumference (abdominal obesity defined as ≥90 cm for men and ≥80 cm for women) were evaluated. During a mean follow‐up of 3.9±1.3 years, 3443 participants (1432 women [41.6%]) developed AF. In multivariable models adjusted for clinical variables, the AF risk of underweight, overweight, and obese individuals increased by 21% (95% confidence interval, 1.01–1.45, P=0.043), 14% (95% confidence interval, 1.06–1.23, P<0.001), and 52% (95% confidence interval, 1.30–1.78, P<0.001), respectively, compared with those with normal body mass index. AF risk with confounder‐adjusted hazards for abdominal obesity was 18% (95% confidence interval, 1.10–1.27, P<0.001). The increased AF risk was present in abdominally obese individuals regardless of body mass index except for the obese group. In subgroup analysis, abdominal obesity by waist circumference conferred increased risk of new‐onset AF, particularly in participants without comorbidities.ConclusionsAbdominal obesity is an important, potentially modifiable risk factor for AF in nonobese Asian persons. These data suggest that interventions to decrease abdominal obesity may reduce the population burden of AF.

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“…This paradox has been described in a number of CV diseases such as CAD, heart failure, and atrial fibrillation (1,5,(34)(35)(36)(37)(38)(39)(40)(41)(42)(43), though conflicting data exists in the literature among certain subgroups of CAD individuals. (35,44,45) The following is a discussion of the obesity paradox in CAD cohorts and its implication.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

The relationship between obesity and coronary artery disease

Jahangir¹,

Schutter²,

Lavie³

2014

Translational Research

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Obesity continues to be a growing issue in the United States with an estimated prevalence of 72 million people. There are major health implications associated with obesity including its relationship with hypertension, diabetes mellitus type 2, the metabolic syndrome, and dyslipidemia, all independent risk factors for CAD. Despite the increased risk of developing CAD, in recent years an "obesity paradox" has been described in which moderately obese individuals with established cardiovascular disease, including CAD, appear to have mortality similar to their normal weight counterparts. This review discusses the relationship between obesity and CAD, including the increased risk of hypertension, diabetes mellitus, the metabolic syndrome, and dyslipidemia along with a discussion of the obesity paradox and the benefits of weight reduction.

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Obesity Paradox in Patients with Hypertension and Coronary Artery Disease

Cited by 475 publications

References 35 publications

Obesity paradox in heart failure: a heavy matter

Obesity paradox in heart failure: a heavy matter

Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

The relationship between obesity and coronary artery disease

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