This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (4) Google Scholar Articles by Lavie, C. J. Articles by Ventura, H. O. PubMed Articles by Lavie, C. J. Articles by Ventura, H. O. Related Collections Related Article

STATE-OF-THE-ART PAPER

Obesity and Cardiovascular Disease

Risk Factor, Paradox, and Impact of Weight Loss

Ochsner Medical Center, New Orleans, Louisiana

Manuscript received October 21, 2008; revised manuscript received December 2, 2008, accepted December 9, 2008.

^_* Reprint requests and correspondence: Dr. Carl J. Lavie, Cardiac Rehabilitation, Exercise Laboratories, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, Louisiana 70121-2483 (Email: clavie{at}ochsner.org).

Obesity has reached global epidemic proportions in both adults and children and is associated with numerous comorbidities, including hypertension (HTN), type II diabetes mellitus, dyslipidemia, obstructive sleep apnea and sleep-disordered breathing, certain cancers, and major cardiovascular (CV) diseases. Because of its maladaptive effects on various CV risk factors and its adverse effects on CV structure and function, obesity has a major impact on CV diseases, such as heart failure (HF), coronary heart disease (CHD), sudden cardiac death, and atrial fibrillation, and is associated with reduced overall survival. Despite this adverse association, numerous studies have documented an obesity paradox in which overweight and obese people with established CV disease, including HTN, HF, CHD, and peripheral arterial disease, have a better prognosis compared with nonoverweight/nonobese patients. This review summarizes the adverse effects of obesity on CV disease risk factors and its role in the pathogenesis of various CV diseases, reviews the obesity paradox and potential explanations for these puzzling data, and concludes with a discussion regarding the current state of weight reduction in the prevention and treatment of CV diseases.

Key Words: obesity • cardiovascular disease • weight loss

Abbreviations and Acronyms   AF = atrial fibrillation   BMI = body mass index   CHD = coronary heart disease   CR = concentric remodeling   CRP = C-reactive protein   CV = cardiovascular   DM = diabetes mellitus   HF = heart failure   HTN = hypertension   LA = left atrial   LV = left ventricular   LVH = left ventricular hypertrophy   MI = myocardial infarction   OSA = obstructive sleep apnea   PAD = peripheral arterial disease   SCD = sudden cardiac death   WC = waist circumference   WHR = waist-to-hip ratio

Related Article

Inside This Issue
J. Am. Coll. Cardiol. 2009 53: A32. [Full Text] [PDF]

This article has been cited by other articles:

				C. J. Lavie and J. Sierra-Johnson Ergo-anthropometric Assessment-Reply-I Mayo Clin. Proc., October 1, 2009; 84(10): 941 - 942. [Full Text] [PDF]

				A. M. Salinas and A. Coca Ergo-anthropometric Assessment Mayo Clin. Proc., October 1, 2009; 84(10): 940 - 941. [Full Text] [PDF]

				C. J. Lavie, F. H. Messerli, and R. V. Milani Beta-blockers as first-line antihypertensive therapy the crumbling continues. J. Am. Coll. Cardiol., September 22, 2009; 54(13): 1162 - 1164. [Full Text] [PDF]

				G. W. Lyerly, X. Sui, C. J. Lavie, T. S. Church, G. A. Hand, and S. N. Blair The Association Between Cardiorespiratory Fitness and Risk of All-Cause Mortality Among Women With Impaired Fasting Glucose or Undiagnosed Diabetes Mellitus Mayo Clin. Proc., September 1, 2009; 84(9): 780 - 786. [Abstract] [Full Text] [PDF]

				J. H. O'Keefe, M. D. Carter, and C. J. Lavie Primary and Secondary Prevention of Cardiovascular Diseases: A Practical Evidence-Based Approach Mayo Clin. Proc., August 1, 2009; 84(8): 741 - 757. [Abstract] [Full Text] [PDF]