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How Does Obesity Cause Heart Disease

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Family History And Cardiovascular Disease Risk

How Does Obesity Affect Heart Disease –

A personâs family history of disease can increase their tendency to develop:

  • Diabetes.
  • A particular body shape.

Although having a family history of CVD is a risk factor you canât change, it does not mean that you will develop it. However, if you do have a family history of CVD, it is important to reduce or remove other risk factors. For example, adopting healthy eating patterns, do not smoke, and lead an active, healthy lifestyle.

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Cholesterol And Cardiovascular Disease Risk

Cholesterol is a fatty substance produced naturally by your body . It is used for many different things in your body but is a problem when thereâs too much of it in your blood.

High total cholesterol causes fatty material to gradually build up in your bodyâs arteries, making it harder for blood to flow through. It is mainly caused by eating foods high in saturated fats and trans fats.

Your total cholesterol includes two types of cholesterol, which are:

  • Low-density lipoprotein â also known as âbadâ cholesterol because it can add to the build-up of plaque in your arteries and increase your risk of heart attack and stroke.
  • High-density lipoprotein is also known as âgoodâ cholesterol because it helps to protect you against heart attack and stroke.

Most of the total cholesterol in your blood is made up of âbadâ LDL cholesterol. Only a small part is made up of âgoodâ HDL cholesterol.

You should aim for low LDL cholesterol and higher HDL cholesterol on advice from your doctor. If you are having trouble with your cholesterol levels, a dietitian can help you to eat healthily for your specific needs.

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How Does Obesity Affect The Heart

Obesity is a leading factor in heart disease and various other cardiac issues. Many changes occur in the heart of a person who is overweight. Usually, the flow and circulation of the blood are increased that may cause fluid retention. Eventually, it can cause the heart to go through volume overload, putting pressure on its working ability.;

More weight means more pressure on the body that can lead to cardiac arrest. When the heart is overloaded with pressure, the left side of the heart gets thicker and larger. This results in heart failure, fatal heart rhythms, or in some cases, sudden death.;

Loose connective tissue, commonly known as the adipose tissue, further promotes the chance of having atherosclerosis. In atherosclerosis, the arteries are hardened and can cause inflammation. A hormone, leptin, is produced, which triggers inflammation. This can, sooner or later, damage the heart cells and replace them with fat cells.;

Another complication of being overweight is sleep apnea. Sleep apnea is sensed if a person complains of daytime sleepiness, snoring at night, or in rare cases, they may stop breathing. The disease badly affects the heart, and the victim is at great risk of heart disease.;

Causes And Consequences Of Obesity

Obesity DOES cause heart disease

Obesity is established from different causes, and although it is true that there may be metabolic and genetic factors resulting in a person being overweight, the main cause of obesity is the imbalance that occurs between the intake of calories and the consumption of them, both through the bodys metabolic reactions and through physical activity.

Obesity has been linked through various studies with a number of diseases, such as type 2 diabetes mellitus, high blood pressure, dyslipidemias, joint and bone disorders, some types of cancer, and respiratory problems.

The fact that obesity produces an increase in the presence of vascular risk factors such as diabetes, high blood pressure, or dyslipidemias means that obesity can be related to an increased risk of suffering from a heart problem, such as a heart attack or some type of arrhythmia.

The presence of obesity problems associated with alterations in the blood pressure and the metabolism of fats and sugars is called metabolic syndrome.

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Obesity Memory And Cognitive Function

Alzheimers disease and dementia are scourges of populations that enjoy a long life span. In the United States, these diseases affect more than 7.5 million people, most of them over age 65. At 65, the estimated lifetime risk for Alzheimers disease is 17.2 percent in women and 9.1 percent in men. Body weight is a potentially modifiable risk factor for Alzheimers disease and dementia. A meta-analysis of 10 prospective cohort studies that included almost 42,000 subjects followed for three to 36 years demonstrated a U-shaped association between BMI and Alzheimers disease. Compared with being in the normal weight range, being underweight was associated with a 36 percent higher risk of Alzheimers disease while being obese was associated with a 42 percent higher risk. The associations were stronger in studies with longer follow-up. A more recent meta-analysis demonstrated a similarly strong association between obesity and Alzheimers disease.

Recommendations On Weight And Heart Risk

Patients and doctors alike often think everythings OK in the absence of diabetes or hypertension. But there may be silent heart injury going on, says Ndumele. ;

Consider the following:

Try to lose weight or control weight. Thats one of the best strategies we now know of to reduce heart failure down the road, Ndumele says.

Know your heart disease risk. Its smart to have your heart risk assessed and know your numbers .

If youre obese, be watchful for signs of heart failure. These include fatigue, shortness of breath and an irregular heartbeat.

Realize that all weight loss helps. For every five-point increase in BMI, the risk of heart failure rose by 32 percent in the study.;

Thanks to John Hopkins Medicine for details of their study reported in this column.

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Increased Cardiovascular Disease Risk

Obesity has consistently been associated with an increased risk for metabolic diseases and cardiovascular disease. An increase in body fat can directly contribute to heart disease through atrial enlargement, ventricular enlargement and atherosclerosis, says Harold Bays, MD, FACC. Further, increased body fat indirectly contributes to heart disease, through promotion of sleep apnea, thromboembolic disease and onset or worsening of metabolic diseases that are major cardiovascular disease risk factors, including dyslipidemia, type 2 diabetes, high blood pressure and metabolic syndrome, Bays says.

In the Cardiovascular Risk in Young Finns Study, repeated measurement of participants height and weight between 1980 and 2011 showed that trajectories of worsening or persisting obesity were associated with an increased risk of cardiovascular disease in adulthood.4 Participants who reduced their elevated childhood body mass index to normal levels had a similar risk for dyslipidemia and hypertension compared with those who were never obese or overweight. Another study demonstrated that an increase in BMI between age seven and early adulthood was associated with an increased risk of type 2 diabetes.5

Help Your Patients Move More

How Obesity Raises Heart Disease Risk | Heart Disease

Encourage your patients to create a plan to move more. Suggest they think of three ways to more naturally fit in time standing or moving. For example:

  • Opt for an activity break to stretch and move rather than a snack or coffee break
  • Walk around or do leg raises during the next conference call
  • Keep stretching bands and/or hand weights near the TV and use commercials as a cue to get up and move
  • Set an alarm at the top of every hour and get out of the chair at work and home

Send your patients to for more tips on increasing physical activity. Download the infographic pictured here to support your conversations with your patients. Post it on the office wall to signal to your patients the importance of being active and to get up and move!

Weight loss is recommended for all overweight or obese patients with comorbid conditions such as prediabetes, diabetes, hypertension and dyslipidemia.6 Recognizing the pathogenic potential of adipose tissue may afford a clearer rationale toward recommending weight reduction to overweight patients. In other words, discussing how fat weight gain causes fat to become sick and how losing body weight causes fat to become more healthy might prove to be more productive than discussing the individual diagnostic components defining the metabolic syndrome, Bays says.


  • Hales CM, Fryar CD, Carroll MD, et al. JAMA 2018;319:2419-29.
  • Ogden CL, Fryar CD, Hales CM, et al. JAMA 2018;319:2410-8.
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    Monitoring Your Condition And Its Health Risks

    You should visit your health care provider periodically to monitor for possible complications,;which if left untreated can be life-threatening. Your doctor may do any of the following to monitor your condition.

    • Assess your weight loss since your last visit. A weight loss of approximately five percent in an overweight patient may improve the function of the fat tissue and help lower bad cholesterol and other substances that can predispose to complications.
    • Measure your waist circumference;if you are an adult. If your waist circumference is greater than 35 inches for women or greater than 40 inches for men, you may be at risk for heart disease, stroke, or type 2 diabetes. South Asians and South and Central Americans have a higher risk of complications, so waist circumference should be smaller than 35 for man and 31 for women. To correctly measure your waist, stand and place a tape measure around your middle, just above your hip bones. Measure your waist just after you breathe out. Visit Assessing Your Weight for more information.
    • Order blood tests to screen for complications. A lipid panel test can check if you have high cholesterol or triglyceride levels in your blood. A liver function test can determine if your liver is working properly. A fasting glucose test can find out if you have prediabetes or diabetes.

    Abnormal Levels Of Blood Fats

    Excess weight raises levels of blood fats cholesterol and triglycerides increasing the risk of coronary heart disease. Excess weight also reduces the level of good cholesterol , which lowers coronary heart disease and stroke risk. So, a lower HDL level adds to heart disease risk, particularly in combination with an elevated level of bad cholesterol.

    Each extra pound increases your hearts workload, requiring it to pump more blood to circulate through fat tissue and with greater force.

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    Available Treatments For Obesity

    In clinical studies, weight loss of around 510% can result in a reduced risk of T2D and cardiovascular disease. Anti-obesity medications increase the likelihood of achieving clinically meaningful weight loss when used as an adjunct to lifestyle intervention. Pharmacological intervention as adjunct to diet and exercise is indicated for individuals with a BMI30 or27;kg/m2 with at least one obesity-related comorbidity.

    The available treatments, currently approved by FDA, EMA and in Brazil, and clinical trials outcomes are described below and summarized in Table;.

    Table;1 Clinical trials outcomes studies for anti-obesity agents

    Blood Pressure And Cardiovascular Disease Risk

    How Does Obesity Cause Heart Failure?

    Blood pressure is the pressure of the blood in your arteries as it is pumped around your body by your heart. Blood pressure depends on two main things: the amount of blood pumped by your heart and how easily the blood can flow through your arteries.

    Your blood pressure will go up and down throughout the day, depending on the time of day and what you are doing. However, high blood pressure is a condition where your blood pressure is consistently high.

    Your family history, eating patterns, alcohol intake, weight and level of physical activity have a strong influence on blood pressure. In some people, medicines, including the oral contraceptive pill, contraceptive âdepotâ injections, steroids and arthritis medicines, can also raise blood pressure.

    High blood pressure can overload your heart and arteries and speed up the artery-clogging process. This can lead to problems such as heart attack and stroke.

    High blood pressure can also affect arteries to other parts of your body, such as the eyes, kidneys and legs.

    If high blood pressure is not treated, your heart may weaken because of the constant extra demand. This may cause âheart failureâ, a serious condition with symptoms such as tiredness, shortness of breath and swelling of the feet and ankles.

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    Confirming A High Body Mass Index

    To diagnose overweight and obesity, doctors measure BMI using calculations that depend on whether you are a child or an adult.

    • Children: A healthy weight is usually when your childs BMI is at the 5th percentile up to less than the 85th percentile based on growth charts for children who are the same age and sex. To figure out your childs BMI, use the Center for Disease Control and Prevention BMI Percentile Calculator for Child and Teen and compare the BMI with the table below.
    • Adults: A healthy weight for adults is usually when your BMI is 18.5 to less than 25. To figure out your BMI, use the National Heart, Lung, and Blood Institutes online BMI calculator and compare it with the table below.;You can also download the BMI calculator app for iPhone and Android. Even if your BMI is in the healthy range, it is possible to be diagnosed as obese if you have a large waist circumference;that suggests increased amounts of fat in your abdomen that can lead to complications.

    Obesity Increases Your Risk Of Developing Other Heart Disease Risk Factors

    These include hypertension, cholesterol abnormalities, and type 2 diabetes, all of which increase your chances of developing cardiovascular disease, notes Nieca Goldberg, MD, a cardiologist and medical director of the Joan H. Tisch Center for Womens Health at the NYU Langone Medical Center in New York City. Being overweight also increases your risk of metabolic syndrome, a cluster of heart-disease risk factors, including high blood pressure, low levels of HDL cholesterol, high triglyceride levels, high blood sugar levels, and a large waist circumference .

    Making matters worse, high blood pressure thats brought on by obesity irritates plaque in the arteries and predisposes it to rupturing, which is what triggers a heart attack, adds Tracy Stevens, MD, a cardiologist at Saint Lukes Mid America Heart Institute in Kansas City, Missouri.

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    Healthy Lifestyle Changes To Prevent Overweight And Obesity

    If your BMI indicates you are getting close to being overweight, or if you have certain risk factors, your doctor may recommend you adopt healthy lifestyle changes to prevent you from becoming overweight and obese. Changes include healthy eating, being physically active, aiming for a healthy weight, and getting healthy amounts of sleep. Read healthy lifestyle changes;for more information

    Smoking And Cardiovascular Disease Risk

    How Does Obesity Affect Heart Disease

    As well as causing cancer, smoking affects the arteries that supply blood to your heart and other parts of your body. It reduces the amount of oxygen in your blood and damages your artery walls.

    Smoking increases your risk of heart attack, stroke and peripheral vascular disease â which can lead to gangrene and limb amputation).

    Smoking makes your blood âstickierâ, causing blood cells to clump together. This slows blood flow through your arteries and makes blockages more common. Blockages may cause heart attack and stroke.

    Smoking also makes your artery walls sticky, causing them to become clogged with fatty material called plaque or atheroma. Smokers often have cold hands or feet as a result of clogged arteries, which may also lead to serious problems such as gangrene.

    If your coronary artery becomes clogged, it can cause angina. If a blood clot forms in the narrowed coronary artery and completely blocks the blood supply to a part of your heart, it can cause a heart attack.

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    Those Extra Pounds Force Your Heart To Work Harder

    Yes, the extra weight youre carrying does put the heart under increased stress, in particular during the relaxation phase of the cardiac cycle whats called the diastole. As the heart fills with blood, theres higher pressure, Goldberg explains. Over time, that can cause people to have heart failure symptoms.

    Its not just the number on the scale that matters. Where the extra weight is distributed also affects your risk of developing heart disease. Simply put, greater amounts of belly fat whats often called central or abdominal obesity is associated with greater inflammation, which is damaging to your heart, Goldberg says. Excess belly fat also increases triglyceride levels, which can contribute to plaque rupturing, Stevens notes. Thats why your waist measurement really does matter, in addition to your overall weight.

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    Obesity And Lung Function/respiratory Disease

    Excess weight impairs respiratory function via mechanical and metabolic pathways. The accumulation of abdominal fat, for example, may limit the descent of the diaphragm, and in turn, lung expansion, while the accumulation of visceral fat can reduce the flexibility of the chest wall, sap respiratory muscle strength, and narrow airways in the lungs. Cytokines generated by the low-grade inflammatory state that accompanies obesity may also impede lung function.

    Asthma and obstructive sleep apnea are two common respiratory diseases that have been linked with obesity. In a meta-analysis of seven prospective studies that included 333,000 subjects, obesity increased the risk of developing asthma in both men and women by 50 percent. Obesity is also a major contributor to obstructive sleep apnea , which is estimated to affect approximately one in five adults; one in 15 adults has moderate or severe obstructive sleep apnea. This condition is associated with daytime sleepiness, accidents, hypertension, cardiovascular disease, and premature mortality. Between 50 percent and 75 percent of individuals with OSA are obese. Clinical trials suggest that modest weight loss can be helpful when treating sleep apnea.

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