Abstract
Obesity is associated with an increased mortality and morbidity for cardiovascular disease (CVD) and adipose tissue is recognised as an important player in obesity-mediated CVD. The diagnosis of the metabolic syndrome (MS) appears to identify substantial additional cardiovascular risk above and beyond the individual risk factors, even though the pathophysiology underlying this evidence is still unravelled.
The inflammatory response related to fat accumulation may influence cardiovascular risk through its involvement not only in body weight homeostasis, but also in coagulation, fibrinolysis, endothelial dysfunction, insulin resistance (IR) and atherosclerosis. Moreover, there is evidence that oxidative stress may be a mechanistic link between several components of MS and CVD, through its role in inflammation and its ability to disrupt insulin-signaling. The cross-talk between impaired insulin-signaling and inflammatory pathways enhances both metabolic IR and endothelial dysfunction, which synergize to predispose to CVD.
Persistent platelet hyperreactivity/activation emerges as the final pathway driven by intertwined interactions among IR, adipokine release, inflammation, dyslipidemia and oxidative stress and provides a pathophysiological explanation for the excess risk of atherothrombosis in this setting.
Despite the availability of multiple interventions to counteract these metabolic changes, including appropriate diet, regular exercise, antiobesity drugs and bariatric surgery, relative failure to control the incidence of MS and its complications reflects both the multifactorial nature of these diseases as well as the scarce compliance of patients to established strategies. Evaluation of the impact of these therapeutic strategies on the pathobiology of atherothrombosis, as discussed in this review, will translate into an optimized approach for cardiovascular prevention.
Keywords: Adipokines, cardiovascular disease, inflammation, insulin resistance, metabolic syndrome, obesity, oxidative stress, platelet activation, pathobiology of atherothrombosis, cardiovascular prevention
Current Medicinal Chemistry
Title: Determinants of Increased Cardiovascular Disease in Obesity and Metabolic Syndrome
Volume: 18 Issue: 34
Author(s): N. Vazzana, F. Santilli, S. Sestili, C. Cuccurullo and G. Davi
Affiliation:
Keywords: Adipokines, cardiovascular disease, inflammation, insulin resistance, metabolic syndrome, obesity, oxidative stress, platelet activation, pathobiology of atherothrombosis, cardiovascular prevention
Abstract: Obesity is associated with an increased mortality and morbidity for cardiovascular disease (CVD) and adipose tissue is recognised as an important player in obesity-mediated CVD. The diagnosis of the metabolic syndrome (MS) appears to identify substantial additional cardiovascular risk above and beyond the individual risk factors, even though the pathophysiology underlying this evidence is still unravelled.
The inflammatory response related to fat accumulation may influence cardiovascular risk through its involvement not only in body weight homeostasis, but also in coagulation, fibrinolysis, endothelial dysfunction, insulin resistance (IR) and atherosclerosis. Moreover, there is evidence that oxidative stress may be a mechanistic link between several components of MS and CVD, through its role in inflammation and its ability to disrupt insulin-signaling. The cross-talk between impaired insulin-signaling and inflammatory pathways enhances both metabolic IR and endothelial dysfunction, which synergize to predispose to CVD.
Persistent platelet hyperreactivity/activation emerges as the final pathway driven by intertwined interactions among IR, adipokine release, inflammation, dyslipidemia and oxidative stress and provides a pathophysiological explanation for the excess risk of atherothrombosis in this setting.
Despite the availability of multiple interventions to counteract these metabolic changes, including appropriate diet, regular exercise, antiobesity drugs and bariatric surgery, relative failure to control the incidence of MS and its complications reflects both the multifactorial nature of these diseases as well as the scarce compliance of patients to established strategies. Evaluation of the impact of these therapeutic strategies on the pathobiology of atherothrombosis, as discussed in this review, will translate into an optimized approach for cardiovascular prevention.
Export Options
About this article
Cite this article as:
Vazzana N., Santilli F., Sestili S., Cuccurullo C. and Davi G., Determinants of Increased Cardiovascular Disease in Obesity and Metabolic Syndrome, Current Medicinal Chemistry 2011; 18 (34) . https://dx.doi.org/10.2174/092986711798184299
DOI https://dx.doi.org/10.2174/092986711798184299 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
Call for Papers in Thematic Issues
Advances in Medicinal Chemistry: From Cancer to Chronic Diseases.
The broad spectrum of the issue will provide a comprehensive overview of emerging trends, novel therapeutic interventions, and translational insights that impact modern medicine. The primary focus will be diseases of global concern, including cancer, chronic pain, metabolic disorders, and autoimmune conditions, providing a broad overview of the advancements in ...read more
Approaches to the treatment of chronic inflammation
Chronic inflammation is a hallmark of numerous diseases, significantly impacting global health. Although chronic inflammation is a hot topic, not much has been written about approaches to its treatment. This thematic issue aims to showcase the latest advancements in chronic inflammation treatment and foster discussion on future directions in this ...read more
Cellular and Molecular Mechanisms of Non-Infectious Inflammatory Diseases: Focus on Clinical Implications
The Special Issue covers the results of the studies on cellular and molecular mechanisms of non-infectious inflammatory diseases, in particular, autoimmune rheumatic diseases, atherosclerotic cardiovascular disease and other age-related disorders such as type II diabetes, cancer, neurodegenerative disorders, etc. Review and research articles as well as methodology papers that summarize ...read more
Chalcogen-modified nucleic acid analogues
Chalcogen-modified nucleosides, nucleotides and oligonucleotides have been of great interest to scientific research for many years. The replacement of oxygen in the nucleobase, sugar or phosphate backbone by chalcogen atoms (sulfur, selenium, tellurium) gives these biomolecules unique properties resulting from their altered physical and chemical properties. The continuing interest in ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Effects of Short Chain Fatty Acids on the Intestinal Barrier
Current Nutrition & Food Science Astaxanthin Attenuates Adiponectin, Calprotectin, miRNA222 and miRNA378 in Obesity induced by High-Fat Diet in Rats
Current Pharmaceutical Biotechnology A Comprehensive Review on Recently Detected Herbal Phytoactives Having Anti-Diabetic Potential for Various Diabetes-Related Complications
Current Traditional Medicine Reactive Oxygen and Nitrogen Species in the Renal Ischemia/Reperfusion Injury
Current Pharmaceutical Design Glycogen Synthase Kinase-3 (GSK-3) Inhibitors as a New Lead for Treating Breast and Ovarian Cancer
Current Drug Targets The Secretin/Pituitary Adenylate Cyclase-Activating Polypeptide/ Vasoactive Intestinal Polypeptide Superfamily in the Central Nervous System
Central Nervous System Agents in Medicinal Chemistry Editorial [Hot topic: Latest Development on Zinc Enzymes (Executive Editor: Georgios A. Spyroulias)]
Current Pharmaceutical Design Tumour Reactions to Hypoxia
Current Molecular Medicine The Arrestin Fold: Variations on a Theme
Current Genomics “Something is Wrong in the Ras Kingdom” - Evidence for the Involvement of p21Ras/MAP Kinase in Autoimmune Diseases
Current Rheumatology Reviews Therapeutic Implications of Immune-endocrine Interactions in the Critically Ill Patients
Current Drug Targets - Immune, Endocrine & Metabolic Disorders Genome-Wide Association Studies of Family Data in Pharmacogenetics: A Case Study
Current Pharmaceutical Design Editorial: [Statins and Cardiovascular Events in Patients with End-Stage Renal Disease on Hemodialysis. The AURORA Results Suggest the Need for Earlier Intervention]
Current Vascular Pharmacology The Antiplatelet Drug Target in Atherosclerotic Diseases
Cardiovascular & Hematological Disorders-Drug Targets Protein-protein Interactions: Network Analysis and Applications in Drug Discovery
Current Pharmaceutical Design Advances in L-Type Calcium Channel Structures, Functions and Molecular Modeling
Current Medicinal Chemistry Engineered Magnetic Core-Shell Structures
Current Pharmaceutical Design Tumour-Specific Uptake of Anti-Cancer Drugs: The Future is Here
Current Drug Metabolism Drug-Induced Aseptic Meningitis
Current Drug Targets - Immune, Endocrine & Metabolic Disorders Meet Our Editorial Board Member:
Current Drug Targets