Relation of Body Weight to Development of Coronary Heart Disease

Abstract

Interrelationships between weight change, serum cholesterol, blood pressure levels, and the risk of developing coronary heart disease have been explored in 5,127 men and women who have been followed over 12 years for signs of initial development of coronary heart disease. Antecedent relative weight and weight gain after age 25 years proved to be strongly related to risk of angina pectoris and sudden death but were unassociated with development of myocardial infarction. An excess risk of angina pectoris and sudden death appeared to exist in obese men both with and without elevations of blood pressure and serum cholesterol, indicating an independent contribution of obesity to the rate of development of these manifestations of coronary heart disease. Unless accompanied by an increase in blood pressure and serum cholesterol level, obesity appeared to play a negligible role in women. Subjects with both these predisposing factors and obesity had a pronounced increase in risk, greater than that associated with either factor alone. The data suggest that overweight may be instrumental in bringing out symptoms of angina pectoris or in precipitating sudden death by imposing an increased workload on a heart with an already compromised coronary circulation.

Increased low density lipoprotein production associated with obesity.

“…9 All the atherogenic effects of obesity, however, may not be through known risk factors; several epidemiological studies suggest that excess body weight is an "independent" risk factor. 40 " 45 The results reported here may partially account for this claim. Art increased turnover of apoLDL itself may be a risk factor for CHD.…”

Fatores de risco cardiovascular e mortalidade: seguimento em longo prazo (até 20 anos) em programa preventivo realizado pela medicina ocupacional

“…A longitudinal study, performed in the city of Framingham 41 , showed the association of obesity with morbimortality due to cardiovascular disease in both sexes and different age ranges. The coexistence of disorders as dyslipidemia, diabetes mellitus and hypertension, made impossible to identify the obesity as an isolated risk factor for cardiovascular disease.…”

Obstáculos diagnósticos e desafios terapêuticos no paciente obeso

“…No presente, é universalmente aceito que obesidade é um fator de risco independente para doença cardíaca isquêmica (12,15,96), principalmente quando associada a acúmulo visceral de gordura, que está presente em 90% dos pacientes obesos com coronariopatia (106). O ganho de peso durante a vida adulta aumenta o risco de doença coronariana e mortalidade em ambos os sexos, independentemente da presença de outros fatores de risco cardiovascular clássicos, sugerindo-se a implicação da hiperinsulinemia no fenômeno trombogênico.…”