Targeting abdominal obesity in cardiology: Can we be effective?

Poirier, Paul

doi:10.1016/s0828-282x(08)71044-4

Cited by 15 publications

(22 citation statements)

References 54 publications

(55 reference statements)

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“…Waist or waist-to-hip ratio has been used as a proxy measure for body fat distribution when investigating the health risk associated with obesity. Abdominal obesity has been reported as a risk factor for CVD world wide and is likely refine the clinical assessment of obesity risk 1 11 16 – 18. Waist circumference measurements are not recommended routinely in children since reference values for children that identify risk over and above the risk from BMI category are not available 4…”

Section: Adiposity Indicesmentioning

confidence: 99%

“…It seems from the data available that there is no basis for choosing thresholds because the mortality rate ratio increased steadily with WC. Nevertheless, from a clinical viewpoint, both indices should probably be assessed and may produce a better definition of “at-risk” obesity,11 34 since recognition and management of obesity after an acute coronary syndrome is simply inadequate 6 35…”

Section: Congestive Heart Failurementioning

confidence: 99%

“…The estimated years of life lost due to obesity differ among races and gender and it was estimated that the optimal BMI for adults aged 18–85 years is 23–25 kg/m 2 for white subjects and 23–30 kg/m 2 for black subjects 9. However, obesity is a remarkably heterogeneous condition 10 11. Obesity as defined by the BMI is undoubtedly associated with an increased rate of comorbidities and cardiovascular mortality10 12 and obese people considered “at risk” are mostly characterised by features associated with metabolic disturbances 12 13.…”

mentioning

confidence: 99%

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Cardiologists and abdominal obesity: lost in translation?

Poirier

2009

Heart

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Section: Adiposity Indicesmentioning

confidence: 99%

Section: Congestive Heart Failurementioning

confidence: 99%

mentioning

confidence: 99%

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Cardiologists and abdominal obesity: lost in translation?

Poirier

2009

Heart

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“…Si l'on inclut les deux sous-populations dans un même essai clinique de prévention ou d'intervention, le mélange des deux effectifs (comparer des « pommes » et des « poires ») risque de rendre l'interprétation des données très problématique [34]. Par ailleurs, si les médecins praticiens et les patients sont de mieux en mieux informés quant au risque associé à l'obésité abdominale [35] et à l'importance de corriger l'adiposité viscérale pour améliorer le pronostic cardiovasculaire [3,36], les recommandations concernant la prise en charge des personnes avec un profil MHO sont quasi inexistantes.…”

Section: Prise En Charge Des Sujets Mho Généralitésunclassified

Metabolically healthy, but obese subjects. Second part: prognosis and management

Esser¹,

Paquot

Scheen

2009

Obes

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“…In fact, excess weight and adiposity indices are not evaluated routinely in a real-life cardiology practice. 13,14 In this context, BMI and WC might both prove useful to clinical practice simply to make clinicians aware of the presence of obesity.…”

Section: Adiposity Indicesmentioning

confidence: 99%

Healthy Lifestyle

Poirier

2008

Circulation

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E pidemiological, metabolic, and clinical studies conducted over the last few decades have identified important factors that contribute to the development of cardiovascular disease (CVD). Accordingly, several modifiable (smoking, blood pressure, lipid/lipoprotein and glucose levels, diabetes mellitus, poor diet, lack of physical activity/ exercise, obesity, and psychosocial factors) and nonmodifiable (age, gender, and genetic predisposition) CVD risk factors are now recognized in contemporary clinical practice. 1 The health hazards of obesity have been recognized for centuries, 2 and in 1998, obesity was reported as a major modifiable risk factor for CVD by the American Heart Association. 3 Article p 3062In this issue of Circulation, Jensen et al 4 report an analysis of the associations of obesity (defined by body mass index [BMI]) in combination with physical activity, smoking, and a Mediterranean diet with the risk of acute coronary syndrome (ACS; defined as unstable angina pectoris and nonfatal and fatal acute myocardial infarction) in a prospective, population-based study of 54 783 middle-aged men and women. The investigators found that the association between BMI and ACS was strong and graded, and the absolute risk was substantially higher among men. Behavioral risk factors such as smoking, relative physical inactivity, low adherence to the Mediterranean diet, and having the lowest alcohol intake were all associated with a higher risk of ACS. Of importance, BMI was associated with risk of ACS at all levels of classic behavioral lifestyle risk factors: physical inactivity, smoking, and unhealthy diet. These findings suggest that obesity is important even in subjects who adhere to an otherwise healthy lifestyle. Adiposity IndicesIn the present study, adiposity status was assessed by BMI, and physical activity was self-reported. Although this prospective study used validated end points, one must consider that assessments of adiposity and physical activity may have introduced biases, which are probably overcome by the size of the study. In the past, lack of statistical power, especially small numbers of outcome events and inadequate length of follow-up, have been potential explanations for studies that failed to find relationships between obesity and morbidity/ mortality. Other considerations include the potential for unmeasured confounders in observational studies and potential misclassification bias from the use of surrogate markers of body fat such as BMI, the impact of which varies across population groups. Thus, inconsistencies of findings between studies may be related to differences in study populations and sampling, measures of adiposity or obesity, and statistical approaches. The present study went to great lengths to avoid such pitfalls.Obesity as defined by BMI is undoubtedly associated with an increased rate of comorbidities and cardiovascular morbidity/mortality, including ACS. 2 Current definitions designate overweight in adults as a BMI of 25.0 to Ͻ30.0 kg/m 2 and obesity as a BMI of Ն30.0 kg/m 2...

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Targeting abdominal obesity in cardiology: Can we be effective?

Cited by 15 publications

References 54 publications

Cardiologists and abdominal obesity: lost in translation?

Cardiologists and abdominal obesity: lost in translation?

Metabolically healthy, but obese subjects. Second part: prognosis and management

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