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Obesity and cardiovascular risk

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Abstract

Obesity has assumed epidemic proportions and is expected to decrease the life expectancy of current and future generations by its cardiovascular complications and other associated chronic diseases. Recognizing the gravity of this trend, the American Heart Association recently identified obesity as an independent and important modifiable risk factor for cardiovascular disease. Obesity is known to cluster with other cardiovascular and metabolic risk factors constituting the cardiometabolic syndrome. The pathophysiogic link between obesity and cardiovascular disease is complex and involves multiple metabolic and inflammatory risk factors. In an attempt to better elucidate this major public health problem, this article reviews obesity as an epidemic, the structural and functional changes in the cardiovascular system as a result of obesity, and the pathophysiology of obesity-related cardiomyopathy. The sheer magnitude of the problem of obesity with its immense cardiovascular consequences warrants immediate intervention.

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References and Recommended Reading

  1. Ogden CL, Carroll MD, Curtin LR, et al.: Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006, 295:1549–1555.

    Article  PubMed  CAS  Google Scholar 

  2. Whitaker RC, Wright JA, Pepe MS, et al.: Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997, 37:869–873.

    Article  Google Scholar 

  3. Olshansky SJ, Passaro DJ, Ronald C, et al.: A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005, 352:1138–1145.

    Article  PubMed  CAS  Google Scholar 

  4. Eckel RH, Kahn R, Robertson RM, Rizza RA: Preventing cardiovascular disease and diabetes: a call to action from the American Diabetes Association and the American Heart Association. Circulation 2006, 113:2943–2946.

    Article  PubMed  Google Scholar 

  5. Galasssi A, Renolds K, He J: Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med 2006, 119:812–819.

    Article  Google Scholar 

  6. Mokdad AH, Bowman BA, Ford BA, et al.: The continuing epidemics of obesity and diabetes in the United States. JAMA 2001, 286:1195–1200.

    Article  PubMed  CAS  Google Scholar 

  7. World Health Organization: Overweight and obesity; fact sheet 311. Available at http://www.who.int/mediacentre/factsheets/fs311/en/index.html. Accessed November 30, 2007.

  8. Weiss R, Dziura J, Burgert TS, et al.: Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004, 350:2363–2374.

    Article  Google Scholar 

  9. Li TY, Rana JS, Manson JE, et al.: Obesity as compared with physical activity in predicting risk of coronary heart disease in women. Circulation 2006, 113:499–506.

    Article  PubMed  Google Scholar 

  10. Van Gaal LF, Mertens IL, De Block CE: Mechanisms linking obesity with cardiovascular disease. Nature 2006, 444:875–880.

    Article  PubMed  Google Scholar 

  11. Wong C, Marwick TH: Obesity cardiomyopathy: pathogenesis and pathophysiology. Nat Clin Pract Cardiovasc Med 2007, 4:436–443.

    Article  PubMed  CAS  Google Scholar 

  12. Kenchaiah S, Evans JC, Levy D, et al.: Obesity and the risk of heart failure. N Engl J Med 2002, 347:305–313.

    Article  PubMed  Google Scholar 

  13. Chiu HC, Kovacs A, Ford DA, et al.: A novel mouse model of lipotoxic cardiomyopathy. J Clin Invest 2001, 107:813–822.

    Article  PubMed  CAS  Google Scholar 

  14. Szczepaniak LS, Dobbins RL, Metzger GJ, et al.: Myocardial triglycerides and systolic function in humans: in vivo evaluation by localized proton spectroscopy and cardiac imaging. Magn Reson Med 2003, 49:417–423.

    Article  PubMed  CAS  Google Scholar 

  15. Iacobellis G, Corradi D, Sharma AM: Epicardial adipose tissue: anatomical, biomolecular and clinical relation to the heart. Nat Cardiovasc Clin Pract Med 2005, 2:536–543.

    Article  Google Scholar 

  16. Wong CY, O’Moore-Sullivan T, Leano R, et al.: Alterations of left ventricular myocardial characteristics associated with obesity. Circulation 2004, 101:3081–3087.

    Article  Google Scholar 

  17. Peterson LR, Waggoner AD, Schechtman KB, et al.: Alterations in left ventricular structure and function in young healthy obese women: assessment by echocardiography and tissue Doppler imaging. J Am Coll Cardiol 2004, 43:1399–1404.

    Article  PubMed  Google Scholar 

  18. Lastra G, Manrique C, Whaley-Connell A, Sowers J: Hypertension and the cardiometabolic syndrome. J Clin Hypertens 2005, 7:471–476.

    Article  Google Scholar 

  19. Okamoto E, Couse T, De Leon H, et al.: Perivascular inflammation after balloon angioplasty of porcine coronary arteries. Circulation 2001, 104:2228–2235.

    Article  PubMed  CAS  Google Scholar 

  20. Safar M, Levy B, Striker-Brodier H: Current perspective on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases. Circulation 2003, 107:2864–2869.

    Article  PubMed  Google Scholar 

  21. Montani JP, Carroll JF, Dwyer TM, et al.: Ectopic fat storage in heart, blood vessels and kidneys in the pathogenesis of cardiovascular diseases. Int J Obes Relat Metab Disord 2004, 28(Suppl 4):S58–S65.

    Article  PubMed  CAS  Google Scholar 

  22. Després JP, Lemieux I: Abdominal obesity and metabolic syndrome. Nature 2006, 444:881–887.

    Article  PubMed  Google Scholar 

  23. Xu H, Barnes GT, Yang Q, et al.: Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 2003, 112:1821–1830.

    PubMed  CAS  Google Scholar 

  24. Cancello R, Henegar C, Viguerie N, et al.: Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes 2005, 54:2277–2286.

    Article  PubMed  CAS  Google Scholar 

  25. Bujalska IJ, Kumar S, Stewart PM: Does central obesity reflect “Cushing’s disease of the omentum”? Lancet 1997, 349:1210–1213.

    Article  PubMed  CAS  Google Scholar 

  26. Ishii T, Masuzaki H, Tanaka T, et al.: Augmentation of 11beta-hydroxysteroid dehydrogenase type 1 in LPS-activated J774.1 macrophages—role of 11beta-HSD1 in pro-inflammatory properties in macrophages. FEBS Lett 2007, 581:349–354.

    Article  PubMed  CAS  Google Scholar 

  27. Cooke JP, Oka RK: Does leptin cause vascular disease? Circulation 2002, 106:1904–1905.

    Article  PubMed  Google Scholar 

  28. Rahmouni K, Haynes WG, Mark AL: Cardiovascular and sympathetic effects of leptin. Curr Hypertens Rep 2002, 4:119–125.

    Article  PubMed  Google Scholar 

  29. Mattioli B, Straface E, Quaranta MG, et al.: Leptin promotes differentiation and survival of human dendritic cells and licenses them for Th1 priming. J Immunol 2005, 174:6820–6828.

    PubMed  CAS  Google Scholar 

  30. Knudson JD, Dincer UD, Zhang C, et al.: Leptin receptors are expressed in coronary arteries, and hyperleptinemia causes significant coronary endothelial dysfunction. Am J Physiol Heart Circ Physiol 2005, 289:H48–H56.

    Article  PubMed  CAS  Google Scholar 

  31. Soderberg S, Ahren B, Stegmayr B, et al.: Leptin is a risk marker for first-ever hemorrhagic stroke in a population-based cohort. Stroke 1999, 30:328–337.

    PubMed  CAS  Google Scholar 

  32. Soderberg S, Ahren B, Jansson JH, et al.: Leptin is associated with increased risk of myocardial infarction. J Intern Med 1999, 246:409–418.

    Article  PubMed  CAS  Google Scholar 

  33. McTernan PG, McTernan CL, Chetty R, et al.: Increased resistin gene and protein expression in human abdominal adipose tissue. J Clin Endocrinol Metab 2002, 87:2407–2410.

    Article  PubMed  CAS  Google Scholar 

  34. Reilly MP, Lehrke M, Wolfe ML, et al.: Resistin is an inflammatory marker of atherosclerosis in humans. Circulation 2005, 111:932–939.

    Article  PubMed  CAS  Google Scholar 

  35. Hotamisligil GS, Arner P, Caro JF, et al.: Increased adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance. J Clin Invest 1995, 95:2409–2415.

    Article  PubMed  CAS  Google Scholar 

  36. Mousa SA: Elevation of plasma von Willebrand factor and tumor necrosis factor-a in obese subjects and their reduction by the low molecular weight heparin tinzaparin. Int Angiol 2005, 24:278–281.

    PubMed  CAS  Google Scholar 

  37. Kern PA, Di Gregorio GB, Lu T, et al.: Adiponectin expression from human adipose tissue: relation to obesity, insulin resistance, and tumor necrosis factor-alpha expression. Diabetes 2003, 52:1779–1785.

    Article  PubMed  CAS  Google Scholar 

  38. Ouchi N, Kihara S, Arita Y, et al.: Novel modulator for endothelial adhesion molecules: adipocyte-derived plasma protein adiponectin. Circulation 1999, 100:2473–2476.

    PubMed  CAS  Google Scholar 

  39. Kumada M, Kihara S, Ouchi N, et al.: Adiponectin specifically increased tissue inhibitor of metalloproteinase-1 through interleukin-10 expression in human macrophages. Circulation 2004, 109:2046–2049.

    Article  PubMed  CAS  Google Scholar 

  40. Ma LJ, Mao SL, Taylor KL, et al.: Prevention of obesity and insulin resistance in mice lacking plasminogen activator inhibitor 1. Diabetes 2004, 53:336–346.

    Article  PubMed  CAS  Google Scholar 

  41. Xiang G, Schuster MD, Seki T, et al.: Down-regulation of plasminogen activator inhibitor 1 expression promotes myocardial neovascularization by bone marrow progenitors. J Exp Med 2004, 200:1657–1666.

    Article  PubMed  CAS  Google Scholar 

  42. Appel SJ, Harrell JS, Davenport ML: Central obesity, the metabolic syndrome, and plasminogen activator inhibitor-1 in young adults. J Am Acad Nurse Pract 2005, 17:535–541.

    Article  PubMed  Google Scholar 

  43. Hamsten A, de Faire U, Walldius G, et al.: Plasminogen activator inhibitor in plasma: risk factor for recurrent myocardial infarction. Lancet 1987, 2:3–9.

    Article  PubMed  CAS  Google Scholar 

  44. Mohamed-Ali V, Goodrick S, Rawesh A, et al.: Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab 1997, 82:4196–4200.

    Article  PubMed  CAS  Google Scholar 

  45. Smith SR, Wilson PW: Free fatty acids and atherosclerosis—guilty or innocent? J Clin Endocrinol Metab 2006, 91:2506–2508.

    Article  PubMed  CAS  Google Scholar 

  46. Pilz S, Scharnagl H, Tiran B, et al.: Free fatty acids are independently associated with all-cause and cardiovascular mortality in subjects with coronary artery disease. J Clin Endocrinol Metab 2006, 91:2542–2547.

    Article  PubMed  CAS  Google Scholar 

  47. Giacchetti G, Faloia E, Mariniello B, et al.: Overexpression of the renin-angiotensin system in human visceral adipose tissue in normal and overweight subjects. Am J Hypertens 2002, 15:381–388.

    Article  PubMed  CAS  Google Scholar 

  48. Janke J, Engeli S, Gorzelniak K, et al.: Mature adipocytes inhibit in vitro differentiation of human preadipocytes via angiotensin type 1 receptors. Diabetes 2002, 51:1699–1707.

    Article  PubMed  CAS  Google Scholar 

  49. Lijnen P, Petrov V: Antagonism of the renin-angiotensin system, hypertrophy and gene expression in cardiac myocytes. Methods Find Exp Clin Pharmacol 1999, 21:363–374.

    Article  PubMed  CAS  Google Scholar 

  50. Keaney JF, Larson MG, Vasan RS, et al.: Obesity and systemic oxidative stress: clinical correlates of oxidative stress in the Framingham Study. Arterioscler Thromb Vasc Biol 2003, 23:434–439.

    Article  PubMed  CAS  Google Scholar 

  51. Hayden MR, Stump CS, Sowers JR: Introduction: organ involvement in the cardiometabolic syndrome. J Cardiometab Syndr 2006, 1:16–24.

    Article  PubMed  Google Scholar 

  52. Furukawa S, Fujita T, Shimabukuro M, et al.: Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest 2004, 114:1752–1761.

    PubMed  CAS  Google Scholar 

  53. Brunner H, Cockcroft JR, Deanfield J, et al.: Endothelial function and dysfunction. Part II: association with cardiovascular risk factors and diseases. A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension. J Hypertens 2005, 23:233–246.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Missouri-Columbia School of Medicine, Health Sciences Center, MA410, DC043.0, One Hospital Drive, Columbia, MO, 65212, USA

    Melvin R. Hayden

Authors
  1. Poorna R. Karuparthi
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  2. Preethi Yerram
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  3. Gurushankar Govindarajan
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  4. Melvin R. Hayden
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Correspondence to Melvin R. Hayden.

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Karuparthi, P.R., Yerram, P., Govindarajan, G. et al. Obesity and cardiovascular risk. Curr Cardio Risk Rep 2, 113–119 (2008). https://doi.org/10.1007/s12170-008-0022-3

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  • DOI: https://doi.org/10.1007/s12170-008-0022-3

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