Relationships Between Obesity and Cardiovascular Diseases

Relationships Between Obesity and Cardiovascular Diseases

Obesity is defined as having a body mass index of over 30. For a person that is 5’9”, this would translate to a body weight of 203 pounds or above. According to the Centers for Disease Control and Prevention, the prevalence of obesity in the United States in 2016 was 39.8%.1 Obesity can lead to multiple health problems, including an increased risk of heart attack or stroke.

Obesity and Heart Disease

The term heart or cardiovascular disease is an umbrella term for multiple conditions impacting the heart. These include: coronary artery disease, stroke, and heart failure among others. All of these conditions have been linked with obesity. 

Coronary artery disease (CAD) involves blockages and hardening of the arteries, preventing blood flow, and eventually leading to a heart attack or stroke. Every 22 pound rise in body weight increases the risk of CAD by 12%.2  Heart attack and stroke risk are also influenced by obesity. The risk of heart attack increases by 4% and strokes by 6% for every one unit rise in BMI.3

Still, the connection between obesity is not black and white. First, the way obesity is currently measured, doesn’t indicate anything about fat distribution on the body. Abdominal obesity is most connected to cardiovascular disease risk, whereas carrying your weight in the hips or thighs is not.4 

The connection between obesity and heart disease may also not be cause and effect. It was previously believed that obesity caused an increased accumulation of body lipids (i.e. cholesterol) which then caused heart disease to develop. 

New research indicates that obesity and heart disease may actually be symptoms of chronic systemic inflammation.5 Heart attacks have been linked to high levels of C-reactive protein, a marker of inflammation. People who are obese also have high inflammation markers and weight loss lowers them.6 So, obesity may not cause heart disease directly, obesity and heart disease may simply be symptoms of the same condition. 

For heart failure, the risk of developing heart failure increases by 5% for men and 7% for women for every one point rise in BMI.7 But, studies have found that for those who have been diagnoised wtih heart failure, those who are obese have a 33% lower risk of all-cause mortaility compared to individuals of a normal weight. The risk of death by heart disease in these patients was 40% less.

Similar prognosis has been found for high blood pressure. Although blood pressure is not as well controlled in individuals with obesity, mortality are 30% lower when compared to those of normal body weight.9 

It is unclear why there is a significantly lower risk of death by heart failure and high blood pressure for those who are obese. Perhaps, heart disease is usually treated earlier in obese patients, compared to those of normal weight. 

      Lifestyle and Diet Changes You Can Make

      Until researchers figure out the exact connection between weight and heart disease, it is still important to try to maintain a healthy weight. The good news is that even if you are overweight, you don’t need to lose all the excess weight to lower your risk of all chronic diseases. Even just a weight loss of 5-10% of your body weight has been found to decrease triglycerides by 40 mg/dL and both systolic and diastolic blood pressure by 5 mmHg. With moderate weight loss inflammation tends to decrease as well. 

      Weight loss isn’t the only thing that matters for decreasing your risk of heart disease, your lifestyle matters as well. Not smoking, regular exercise, and adopting a healthy Mediterranean style diet can also lower risk. Body weight is just one factor in the development of chronic disease. Living a healthy lifestyle goes a long way as well, regardless of weight. 

       

      References

      1. Adult Obesity Facts. Centers for Disease Control and Prevention. Reviewed August 13, 2018.
      2. Circulation. 2007; 116(13):1488–1496.
      3. Journal of the American College of Cardiology. 2009;53(21): 1925–1932.
      4. Circulation. 2008: 118(5): 482–490.
      5. Nature Reviews Cardiology. 2009;6(6):399–409.
      6. JAMA. 2003;289(14): 1799–1804.
      7. The New England Journal of Medicine. 2002;347(5):305–313.
      8. Chest. 2008;134:896–898. 
      9. Hypertension. 1991;17:553–564.
      10. NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. 
      11. Journal of Diabetes Research, 2018.

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