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Cardiovascular Diseases and Obesity

February 9, 2021
Cardiovascular disease is the main cause of death worldwide. It is estimated that about 17.9 million people died due to cardiovascular diseases in 2016, which represents 31% of total global deaths. In fact, about 75% of cardiovascular deaths occur in low and middle-income countries. Besides being the first and fifth cause of death respectively, heart disease and stroke can also cause major illness and disability that can severely decrease the Quality of Life (QoL). However, majority of cardiovascular diseases are preventable through behavioral changes, such as addressing tobacco use, unhealthy diet, physical inactivity, obesity, and alcohol consumption.

Obesity as a cardiovascular risk factor

Excess body fat in obese individuals is detrimental to health in many ways. Research suggests a strong correlation between obesity and cardiovascular health. Individuals with a body mass index (BMI) above 40 kg/m2 have extremely high risk for cardiovascular diseases, including sudden death. Accumulation of fat, especially around the waist increases the likelihood of developing heart disease and stroke. The percentage of body fat (PBF) is also independently associated with cardiovascular risk factors.

Additionally, obesity can have significant impact on the cholesterol levels. Obese individuals have increased low density lipids (LDL) and triglycerides. Triglycerides and LDL (bad cholesterol) contribute to thickening of arteries, a process known as atherosclerosis that is considered as a leading cause of heart attack or stroke. In contrast, HDL carries bad cholesterol from the bloodstream to the liver and helps to eliminate them from the body, thereby minimizing the risk of heart disease. But obese people have reduced levels of HDL that increases their risk of developing heart disease.

Hypertension is also a common condition associated with obesity. It is deemed to be a major risk factor for cardiovascular diseases. Population studies suggest that about 75% of hypertension cases have obesity as their primary cause. About 50%-60% of obese individuals have mild to moderate hypertension, whereas 5%-10% of obese individuals experience severe hypertension.

The increase in the overall requirement of oxygen and nutrients through blood rises in obese individuals, which is responsible for the increased blood pressure. The demand of blood supply from the heart also increases in obese people due to the blood flow that supplies the extra adipose tissue. An increase in each 10 kg of body weight is associated with an increase in 3.0 mmHg systolic and 2.3 mmHg of diastolic blood pressure. The increased blood pressure can increase the risk of coronary heart disease by 12% and stroke risk by 24% respectively. The demand for increased blood supply can also lead to enlargement of heart chamber and thickening of the heart muscles. Consequently, the performance of the heart may be reduced in terms of its ability to contract and relax normally, leading to heart failure.

Obese individuals carry much higher risk of developing type 2 diabetes, a well-known risk factor for cardiovascular disease. Not all people with obesity develop diabetes, but about 90% of patients with type 2 diabetes are at least overweight. Diabetes patients are two to four times more likely to carry a risk for heart disease. It is also listed as the one of the top seven modifiable risk factors for the prevention of heart disease. Indeed, cardiovascular disease remains as the primary cause of death in diabetes patients.

Addressing obesity-related cardiovascular risks

Losing weight could be challenging many a times, but sustained weight loss is proven to reduce several cardiac-related risks in obese people. Many conventional therapies including diet, physical activity, pharmacotherapy, or bariatric procedures are considered as ideal treatments for obesity. However, dietary alterations and physical activity remain as important elements for positive and sustainable weight loss. Many studies demonstrate that weight loss improves many obesity-related cardiac conditions. In addition to its key role in preventing health aliments, weight loss can also reverse some of the significant health problems. Losing about three to five percent of the body weight helps to reduce some risk factors, while higher and sustained weight loss can restore blood pressure, glucose, and cholesterol levels back to normal. Improvement in heart and vascular health is observed in greater extent, even with moderate weight loss. One of the crucial benefits of weight-loss on the cardiovascular system is the decreased stress on the heart, thereby promoting significant improvements in its structure and function. Studies on obese patients involved in weight loss program reveal improvement in key measures related to heart and vascular health. The ability of contraction and relaxation of heart along with thickness of the heart muscle tissue, and the thickness of the carotid artery walls are enhanced. Such benefits continue even after the individuals stop losing weight or regain weight to some extent. Hence, behavioral strategies including diet and activity along with self-monitoring are considered as key factors to combat obesity related cardiovascular risks.

References :

  1. Mittendorfer B, Peterson LR. Cardiovascular Consequences of Obesity and Targets for Treatment. Drug Discov Today Ther Strateg. 2008;5(1):53-61.
  2. Three Ways Obesity Contributes to Heart Disease https://www.pennmedicine.org/updates/blogs/metabolic-and-bariatric-surgery-blog/2019/march/obesity-and-heart-disease Accessed on 07.August.2020
  3. The Effects of Obesity on the Cardiopulmonary System: Implications for Critical Care Nursing https://www.medscape.com/viewarticle/495041_6 Accessed on 07.August.2020
  4. Zeng Q, Dong SY, Sun XN, Xie J, Cui Y. Percent body fat is a better predictor of cardiovascular risk factors than body mass index. Braz J Med Biol Res. 2012;45(7):591-600.
  5. Fight fat to help your heart https://www.health.harvard.edu/heart-health/fight-fat-to-help-your-heart Accessed on 07.August.2020
  6. Heart Disease and Stroke Statistics-2019 At-a-Glance https://healthmetrics.heart.org/wp-content/uploads/2019/02/At-A-Glance-Heart-Disease-and-Stroke-Statistics-%E2%80%93-2019.pdf Accessed on 07.August.2020

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Cardiovascular Diseases and Obesity

Cardiovascular disease is the main cause of death worldwide. It is estimated that about 17.9 million people died due to cardiovascular diseases in 2016, which represents 31% of total global deaths. In fact, about 75% of cardiovascular deaths occur in low and middle-income countries. Besides being the first and fifth cause of death respectively, heart disease and stroke can also cause major illness and disability that can severely decrease the Quality of Life (QoL). However, majority of cardiovascular diseases are preventable through behavioral changes, such as addressing tobacco use, unhealthy diet, physical inactivity, obesity, and alcohol consumption.

Obesity as a cardiovascular risk factor

Excess body fat in obese individuals is detrimental to health in many ways. Research suggests a strong correlation between obesity and cardiovascular health. Individuals with a body mass index (BMI) above 40 kg/m2 have extremely high risk for cardiovascular diseases, including sudden death. Accumulation of fat, especially around the waist increases the likelihood of developing heart disease and stroke. The percentage of body fat (PBF) is also independently associated with cardiovascular risk factors.

Additionally, obesity can have significant impact on the cholesterol levels. Obese individuals have increased low density lipids (LDL) and triglycerides. Triglycerides and LDL (bad cholesterol) contribute to thickening of arteries, a process known as atherosclerosis that is considered as a leading cause of heart attack or stroke. In contrast, HDL carries bad cholesterol from the bloodstream to the liver and helps to eliminate them from the body, thereby minimizing the risk of heart disease. But obese people have reduced levels of HDL that increases their risk of developing heart disease.

Hypertension is also a common condition associated with obesity. It is deemed to be a major risk factor for cardiovascular diseases. Population studies suggest that about 75% of hypertension cases have obesity as their primary cause. About 50%-60% of obese individuals have mild to moderate hypertension, whereas 5%-10% of obese individuals experience severe hypertension.

The increase in the overall requirement of oxygen and nutrients through blood rises in obese individuals, which is responsible for the increased blood pressure. The demand of blood supply from the heart also increases in obese people due to the blood flow that supplies the extra adipose tissue. An increase in each 10 kg of body weight is associated with an increase in 3.0 mmHg systolic and 2.3 mmHg of diastolic blood pressure. The increased blood pressure can increase the risk of coronary heart disease by 12% and stroke risk by 24% respectively. The demand for increased blood supply can also lead to enlargement of heart chamber and thickening of the heart muscles. Consequently, the performance of the heart may be reduced in terms of its ability to contract and relax normally, leading to heart failure.

Obese individuals carry much higher risk of developing type 2 diabetes, a well-known risk factor for cardiovascular disease. Not all people with obesity develop diabetes, but about 90% of patients with type 2 diabetes are at least overweight. Diabetes patients are two to four times more likely to carry a risk for heart disease. It is also listed as the one of the top seven modifiable risk factors for the prevention of heart disease. Indeed, cardiovascular disease remains as the primary cause of death in diabetes patients.

Addressing obesity-related cardiovascular risks

Losing weight could be challenging many a times, but sustained weight loss is proven to reduce several cardiac-related risks in obese people. Many conventional therapies including diet, physical activity, pharmacotherapy, or bariatric procedures are considered as ideal treatments for obesity. However, dietary alterations and physical activity remain as important elements for positive and sustainable weight loss. Many studies demonstrate that weight loss improves many obesity-related cardiac conditions. In addition to its key role in preventing health aliments, weight loss can also reverse some of the significant health problems. Losing about three to five percent of the body weight helps to reduce some risk factors, while higher and sustained weight loss can restore blood pressure, glucose, and cholesterol levels back to normal. Improvement in heart and vascular health is observed in greater extent, even with moderate weight loss. One of the crucial benefits of weight-loss on the cardiovascular system is the decreased stress on the heart, thereby promoting significant improvements in its structure and function. Studies on obese patients involved in weight loss program reveal improvement in key measures related to heart and vascular health. The ability of contraction and relaxation of heart along with thickness of the heart muscle tissue, and the thickness of the carotid artery walls are enhanced. Such benefits continue even after the individuals stop losing weight or regain weight to some extent. Hence, behavioral strategies including diet and activity along with self-monitoring are considered as key factors to combat obesity related cardiovascular risks.

References :

  1. Mittendorfer B, Peterson LR. Cardiovascular Consequences of Obesity and Targets for Treatment. Drug Discov Today Ther Strateg. 2008;5(1):53-61.
  2. Three Ways Obesity Contributes to Heart Disease https://www.pennmedicine.org/updates/blogs/metabolic-and-bariatric-surgery-blog/2019/march/obesity-and-heart-disease Accessed on 07.August.2020
  3. The Effects of Obesity on the Cardiopulmonary System: Implications for Critical Care Nursing https://www.medscape.com/viewarticle/495041_6 Accessed on 07.August.2020
  4. Zeng Q, Dong SY, Sun XN, Xie J, Cui Y. Percent body fat is a better predictor of cardiovascular risk factors than body mass index. Braz J Med Biol Res. 2012;45(7):591-600.
  5. Fight fat to help your heart https://www.health.harvard.edu/heart-health/fight-fat-to-help-your-heart Accessed on 07.August.2020
  6. Heart Disease and Stroke Statistics-2019 At-a-Glance https://healthmetrics.heart.org/wp-content/uploads/2019/02/At-A-Glance-Heart-Disease-and-Stroke-Statistics-%E2%80%93-2019.pdf Accessed on 07.August.2020