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Current Hypertension Reports

Erschienen in:

01.04.2010

The Obesity Paradox and Cardiovascular Disease

verfasst von: Stephen A. Morse, Rajat Gulati, Efrain Reisin

Erschienen in: Current Hypertension Reports | Ausgabe 2/2010

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Abstract

Obesity is increasingly recognized as a global pandemic that threatens the health of millions of people. Obesity is considered to be an important cardiovascular risk factor, but there is increasing evidence that patients with elevated body mass index may be better off than others if they develop cardiovascular or renal disease. This phenomenon has been described as the "obesity paradox" or "reverse epidemiology." This article reviews some recent publications that have studied this phenomenon as it relates to heart failure, coronary artery disease, peripheral arterial disease, kidney disease, and a cohort of patients undergoing nonbariatric surgery.

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•• Strandberg TE, Strandberg AY, Salomaa VV, et al.: Explaining the obesity paradox: cardiovascular risk, weigh change, and mortality during long-term follow-up in men. Eur Heart J 2009, 30(14):1720–1727. The aim of this study was to look at cardiovascular morbidity and mortality compared with the trajectory of weight gain and loss over the lifetime of the participants in a cohort of the Helsinki Businessmen Study, in which BMI and CVD risk factor data were acquired from 1974 to the present. It is a small study but it has shed some light on differences and on the significance of weight gain and loss during midlife and late life. CrossRefPubMed

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•• Lavie CJ, Milani RV, Artham SM, et al.: The obesity paradox, weight loss and coronary disease. Am J Med 2009,122(12):1106–1114. The authors of this study have published extensively on the issue of the obesity paradox and present a small study consisting of 529 participants. The study is significant in that it addresses the question of weight loss or purposeful weight loss in cardiac patients undergoing rehabilitation and exercise training (CRET). Their findings that purposeful weight loss is associated with a trend towards lower mortality and improvement in CVD indices and quality of life is significant and will need to be addressed in larger, well-powered studies in different cohorts. CrossRefPubMed

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•• Prospective Studies Collaboration, Whitlock G, Lewington S, et al.: Body-mass index and cause-specific mortality in 900,000 adults: collaborative analyses of 57 prospective studies. Lancet 2009, 373:1083–1096. This collaborative study is certainly well powered and addresses the issue of BMI and cause-specific mortality. It is significant in that it clearly associates increased morbidity and mortality with increased increments of BMI and confirms the classic understanding of the risks of increased weight.CrossRefPubMed

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Titel: The Obesity Paradox and Cardiovascular Disease
verfasst von: Stephen A. Morse
Rajat Gulati
Efrain Reisin
Publikationsdatum: 01.04.2010
Verlag: Current Science Inc.
Erschienen in: Current Hypertension Reports / Ausgabe 2/2010
Print ISSN: 1522-6417
Elektronische ISSN: 1534-3111
DOI: https://doi.org/10.1007/s11906-010-0099-1

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