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Obesity and Cardiac Disease

Metabolic Syndrome

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Abstract

Obesity contributes to the development of cardiac disease in several ways. It is both an independent risk factor for cardiovascular disease and a facilitative risk factor for coronary artery disease and its complications through its association with a variety of other traditional and nontraditional risk factors. Central obesity is a key component of the metabolic syndrome. There is substantial epidemiologic evidence of an association between overweightness and obesity and coronary heart disease. Evidence of an association based on autopsy and coronary angiography is less convincing. An increasing body of evidence supports the existence of an obesity paradox with respect to mortality in patients with coronary heart disease once it is established. Whether purposeful weight loss improves cardiovascular outcomes in overweight or obese patients is uncertain. Obesity is also a risk factor for the development of heart failure and may serve as the sole or predominant cause in individuals who are severely obese. Obesity produces alterations in cardiac hemodynamics and cardiac morphology that may predispose to left ventricular diastolic and less commonly systolic dysfunction. Prolonged exposure to these conditions and the presence of comorbidities such as hypertension, sleep apnea, and obesity hyperventilation predispose to heart failure. Purposeful weight loss is capable of reversing most of the abnormalities of cardiac structure and function associated with obesity. To an even greater extent than with coronary artery disease, an obesity paradox exists with respect to heart failure such that the risk of mortality is lower in overweight and mildly obese persons than in underweight or normal weight individuals.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, University of Missouri-Columbia, School of Medicine, Columbia, MO, USA

    Martin A. Alpert & Brent M. Parker

  2. Health Sciences Center, University of Missouri, Room CE-33, 5 Hospital Drive, Columbia, MO, 65212, USA

    Martin A. Alpert

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    Rexford S. Ahima

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Alpert, M.A., Parker, B.M. (2015). Obesity and Cardiac Disease. In: Ahima, R. (eds) Metabolic Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-12125-3_35-1

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  1. Latest

    Obesity and Cardiovascular Disease
    Published:
    25 July 2023

    DOI: https://doi.org/10.1007/978-3-319-12125-3_35-2

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    Obesity and Cardiac Disease
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    16 July 2015

    DOI: https://doi.org/10.1007/978-3-319-12125-3_35-1

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