Author + information
- Received October 21, 2008
- Revision received December 2, 2008
- Accepted December 9, 2008
- Published online May 26, 2009.
- Carl J. Lavie, MD⁎ (, )
- Richard V. Milani, MD and
- Hector O. Ventura, MD
- ↵⁎Reprint requests and correspondence:
Dr. Carl J. Lavie, Cardiac Rehabilitation, Exercise Laboratories, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, Louisiana 70121-2483
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.
- Received October 21, 2008.
- Revision received December 2, 2008.
- Accepted December 9, 2008.
- American College of Cardiology Foundation