Obesity And Heart Attacks

The Weightheart Failure Connection

Heart failure is the organs inability to keep up efficiently with the demands placed on it. And its becoming more and more common, Ndumele says. Lots of factors can cause heart failure, and the obesity epidemic is likely a contributor, he says. By 2030, one in five adults may have heart failure.

Its new thinking that obesity itself can lead to heart failureeven in the absence of known markers for heart disease, such as high blood pressure, diabetes and elevated cholesterol.

Obesity Increases Hf Risk

Data resulting from the Framingham study initially suggested that overweight and obesity increase the risk of developing HF.38 While obesity remains a strong risk factor for all forms of HF, recent data suggest that obesity specifically increases the risk of a specific form of HF, termed heart failure with preserved ejection fraction due to HF signs/symptoms in the presence of a normal left ventricular ejection fraction .39 HFpEF accounts for nearly half of all HF diagnoses and with limited therapeutic options. It has been recently proposed that because overweight/obesity are so prevalent in this population,40 targeted therapeutics for patients with concomitant obesity and HFpEF should be developed to improve outcomes.4143

Obesity and risk for heart failure. Obesity increases the risk of heart failure , particularly of HF with preserved ejection fraction compared to HF with reduced ejection fraction . Reprinted from J Am Coll Cardiol, 69, Pandey A, LaMonte M, Klein L, et al, Relationship between physical activity, body mass index, and risk of heart failure, :11291142, Copyright , with permission from Elsevier.39

Abbreviations: IL, interleukin LV, left ventricular LVH, LV hypertrophy SVR, systemic vascular resistance TNF-, tumor necrosis factor .

Obesity And Heart Disease

Summer 2015

Obesity is a complex, chronic disease that should be properly assessed and treated seriously. It is second only to smoking tobacco as the leading cause of preventable death in the United States. According to Center for Disease Control and Prevention , in 2011-2012 more than one-third of adults and one-sixth of children and adolescents in the United States were affected by obesity.

Obesity is defined as having a body mass index equal or greater than 30 kg/m2 which increases the risk for multiple chronic conditions such as type 2 diabetes, hypertension, heart disease, musculoskeletal disease, cancer, obstructive sleep apnea, kidney disease and abnormal cholesterol, among other health conditions. These chronic conditions not only have a great impact on the quality of an individuals life, but they also contribute to higher healthcare cost and decreased work productivity.

According to World Health Organization, Cardiovascular Disease , defined as disorders of the heart and blood vessels, is the number one cause of death globally. Multiple risk factors contribute to CVD. These can be divided into modifiable and non-modifiable risk factors:

Obesity is an independent risk factor for CVD, negatively affecting the hearts function and structure as well as the blood vessels inner lining. Obesity affects the heart through risk factors, such as:

• Elevated Blood Glucose

Heart Failure

Atrial Fibrillation

Coronary Heart Disease

Stroke

Venous Thromboembolism

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Taking Action To Protect Your Heart

The news isnt entirely bad, though. If youre overweight or obese, slimming down can help you reduce your risk of developing heart disease. When people lose as little as 5 pounds, we can start to see improvements in blood pressure, blood sugar, cholesterol levels, and inflammatory factors, Goldberg says. All of these changes are beneficial for your heart.

Indeed, losing excess weight helps with primary prevention of heart disease, as well as secondary prevention , Goldberg says. For secondary prevention, she adds, youll need to take medicine, but maybe less of it if you lose weight.

Its not an easy process, Goldberg admits, but the best ways to lose weight are to improve your diet and exercise habits with the goal of losing 1 pound per week. Keep in mind: If your BMI is in the higher range, its safer to go into a medically supervised weight loss program than to try to do it on your own, Goldberg says.

If youre doing it on your own, stick with a diet thats filled with fruits and vegetables, whole grains, low-fat dairy products, fatty fish and skinless poultry, nuts and legumes, and healthy cooking oils, such as olive, walnut, sesame, or grapeseed oils. Avoid added sugars, highly processed foods, and fried foods. On the exercise front, do a combination of aerobic exercise and weight training to increase your muscle mass and decrease body fat, Goldberg suggests.

Major Risk Factors That Cant Be Changed

You may be born with certain risk factors that cannot be changed. The more of these risk factors you have, the greater your chance of developing coronary heart disease. Since you cant do anything about these risk factors, its even more important that you manage your risk factors that can be changed.

Increasing Age

The majority of people who die of coronary heart disease are 65 or older. While heart attacks can strike people of both sexes in old age, women are at greater risk of dying .

Male gender

Men have a greater risk of heart attack than women do, and men have attacks earlier in life.

Even after women reach the age of menopause, when womens death rate from heart disease increases, womens risk for heart attack is less than that for men.

Heredity

Children of parents with heart disease are more likely to develop heart disease themselves.

African-Americans have more severe high blood pressure than Caucasians, and a higher risk of heart disease. Heart disease risk is also higher among Mexican-Americans, American Indians, native Hawaiians and some Asian-Americans. This is partly due to higher rates of obesity and diabetes.

Most people with a significant family history of heart disease have one or more other risk factors. Just as you cant control your age, sex and race, you cant control your family history. So, its even more important to treat and control any other modifiable risk factors you have.

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Obesity And Heart Failure: Focus On The Obesity Paradox

• Salvatore CarboneCorrespondenceCorrespondence: Address to Salvatore Carbone, MS, Pauley Heart Center, Virginia Commonwealth University, West Hospital 5th Floor, Room 520, 1200 E Broad St, PO Box 980204, Richmond, VA 23298.Pauley Heart Center, Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VADepartment of Experimental Medicine, Sapienza University of Rome, Rome, Italy
• Carl J. LavieAffiliationsJohn Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA
• Ross ArenaAffiliationsDepartment of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL

Smoking And Secondhand Smoke Exposure

Smoking is a major cause of heart disease and stroke and causes 1 in every 4 deaths from these conditions. Smoking can damage the body several ways by:

• Raising triglycerides and lowering high-density lipoprotein cholesterol, also called good cholesterol.
• Making blood sticky and more likely to clot, which can block blood flow to the heart and brain.
• Damaging cells that line the blood vessels.
• Increasing the buildup of plaque in blood vessels.
• Causing thickening and narrowing of blood vessels.

About 34 million US adults smoke cigarettes, and every day, about 1,600 young people under age 18 try their first cigarette.

CDCs Response

CDCs Office on Smoking and Health is at the forefront of the nations efforts to reduce deaths and prevent chronic diseases that result from commercial* tobacco use, including heart disease and stroke. OSH prioritizes health equity by creating resources and opportunities for all people to be as healthy as possible.

CDC and its partners promote efforts to:

• Prevent young people from starting to use tobacco.
• Promote quitting among adults and young people.
• Reduce peoples exposure to secondhand smoke.
• Advance health equity by identifying and eliminating tobacco-related disparities.

Tips connects people who smoke with resources to help them quit, including 1-800-QUIT-NOW, which directs people to free services from their state quitlines.

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Walks To Set Your Tail Wagging

LET GLEN AND IDRIS TAKE THE LEAD…

What is it?

Cariad Pet Therapy, long dog walks with pets who offer mental health support in Barry Sidings Country Park, just outside Pontypridd, South Wales.

Tell me more

Most days, border collie Gwen and labradoodle Idris, pictured with walkers, bring cheer to hospices and schools. But every Thursday morning, anyone suffering loneliness or mental health struggles can join them alongside a small group of locals for a long walk around the park.

Idris’s owner Louise Franklin, 58, says: ‘People say they’re much happier after going out with the dogs. Some of them would never be able to own their own pet, so this is their chance to really get to spend time with one, and meet new people too.’

Sign me up!

How Obesity Impacts Cardiovascular Health

Obesity makes most forms of cardiovascular disease more likely. It does that in a few different ways.

At the most basic level, the extra weight forces the heart to do more work. It can also cause problems by increasing the risk of developing many other factors that make heart disease more likely. High blood pressure, unhealthy cholesterol levels, and even diabetes have been linked to obesity. They cause problems on their own while also increasing the risk of severe cardiovascular issues.

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What You Can Do About It

Amidst all the risks, there are several steps you can follow to lose excess weight, follow a healthy diet and prevent heart disease risk.

Obese individuals whose families have a history of cardiovascular diseases, should follow regular exercise and eat a nutritious and balanced diet. It is advisable to consult your doctor who can form a diet for you according to your body and health status.

For many people, exercising and following a diet is not enough to lose weight. Bariatric surgery is advisable if your body mass index is higher than 35. It is effective and safe for obese individuals and also helps in maintaining blood pressure, high cholesterol and diabetes.

If you think bariatric surgery is the right option for you, your cardiologist can prescribe you a cardiac clearance. When blood pressure, heart disease and high cholesterol are untreated, youre at a high risk of developing complications after the surgery. Consult your cardiologist who will monitor your levels of cholesterol and blood pressure, which can help you know if you should go for the surgery.

Relationship Between Obesity Diabetes And Heart Attack

Obesity increases the risk of diabetes, high blood pressure, and heart attacks significantly. A person with obesity is three times more likely to have a heart attack rather than a healthy individual. It is the proximal trigger that stimulates the blood sugar and cardiovascular diseases. In this article, we will learn about the relation between obesity, diabetes, and heart attack.

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Hfref: Higher Fitness May Negate The Obesity Paradox

In the MECKI Score Research Group study, 4,623 patients with HFrEF underwent maximum cardiopulmonary exercise testing at enrollment and were followed for a median of 3 years. The population was divided according to BMI and peak Vo2. On univariate analysis, groups with higher BMI and peak Vo2 had lower mortality. However, when groups were matched for age, sex, left ventricular ejection fraction , and predicted peak Vo2, the protective role of BMI disappeared.

Other Factors That Contribute To Heart Disease Risk

Stress

Individual response to stress may be a contributing factor for heart attacks.

Some scientists have noted a relationship between coronary heart disease risk and stress in a persons life, along with their health behaviors and socioeconomic status. These factors may affect established risk factors.

For example, people under stress may overeat, start smoking or smoke more than they otherwise would.

Get stress management tips and tools.

Alcohol

Drinking too much alcohol can raise blood pressure, and increase your risk for cardiomyopathy, stroke, cancer and other diseases. It can also contribute to high triglycerides, and produce irregular heartbeats. Additionally, excessive alcohol consumption contributes to obesity, alcoholism, suicide and accidents.

All that said, there is a protective benefit to moderate alcohol consumption.

If you drink, limit your alcohol consumption to no more than two drinks per day for men and no more than one drink per day for women. The National Institute on Alcohol Abuse and Alcoholism defines one drink as 1 1/2 fluid ounces of 80-proof spirits , 5 fl. oz. of wine or 12 fl. oz. of regular beer.

It is not recommended that nondrinkers start using alcohol or that drinkers increase the amount they drink.

Read our recommendation on alcohol and cardiovascular disease.

Diet and nutrition

To maintain a healthy weight, coordinate your diet with your physical activity level so youre using up as many calories as you take in.

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Benefit Of Fitness In Cardiovascular Disease

The effect of cardiorespiratory fitness on CV outcomes is an active area of clinical research. The standard for measuring cardiorespiratory fitness is cardiopulmonary exercise testing, using an incremental treadmill or upright cycle protocol. Numerous studies have found associations between poor CV disease outcomes and low peak exercise oxygen uptake .,

Obesity Is Associated With Hidden Inflammation

This sneaky inflammation and the inflammatory factors it releases increase your risk of developing atherosclerosis and the buildup of plaque in the walls of the arteries. Obesity also releases substances in the blood that can make plaque rupture, which is what leads to heart attacks, Dr. Stevens explains. Obesity is like broken glass to our arteries.

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Obesity Can Compromise Your Hearts Ability To Function

Research shows that obesity can raise your risk of developing atrial fibrillation, a rapid irregular heartbeat of the upper chambers of the heart that can promote the formation of blood clots and lead to stroke, heart failure, or other heart-related complications, according to the American Heart Association. In addition, obesity can lead to enlargement of the heart, which could be from untreated hypertension, Dr. Goldberg says.

Understand Your Risks To Prevent A Heart Attack

Knowledge is power. Understand the risks you face for heart attack.

Extensive research has identified factors that increase a persons risk for coronary heart disease in general and heart attack in particular.

The more risk factors you have, and the greater the degree of each risk factor, the higher your chance of developing coronary heart disease a common term for the buildup of plaque in the hearts arteries that could lead to heart attack. Risk factors fall into three broad categories:

Major risk factors Research has shown that these factors significantly increase the risk of heart and blood vessel disease.

Modifiable risk factors Some major risk factors can be modified, treated or controlled through medications or lifestyle change.

Contributing risk factors These factors are associated with increased risk of cardiovascular disease, but their significance and prevalence havent yet been determined.

The American Heart Association recommends focusing on heart disease prevention early in life. To start, assess your risk factors and work to keep them low. The sooner you identify and manage your risk factors, the better your chances of leading a heart-healthy life.

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Why Is Obesity On The Rise

The numbers are clear that we collectively and often individually struggle with weight in the U.S. The reason why is a strange combination of clear and mysterious. The variables associated with excess weight and obesity include for our modern society include:

• Our convenience-based society allows for less movement. The car, computer, elevator and other conveniences have given us the ability to take the easy way out instead of using our body as intended.

• Our access to cheap, processed food is greater than ever with fast-food shops everywhere and the increasing ability to order fast-food via delivery services. Salty, fatty, sugary foods surround us via car, phone or mobile app 24/7.

• Our busy lifestyles seem counterintuitive to all our conveniences, but we work longer hours and focus less on healthy eating.

• Our lack of physical activity overall means we consume unhealthy foods, deal with stress from long work hours and don’t move our bodies enough to burn calories and reduce stress.

However, we can combat these issues if we find ourselves subject to them. We need to build self-awareness about our expanding waistlines and how they can turn to obesity or increased obesity and disease without our best efforts.

Obesity Sugar And Heart Health

Over the last half century, obesity rates have skyrocketed. In 1962, 46percent of adults in the U.S. were considered overweight or obese. By 2010,that figure had jumped to 75 percent.

Obesity is a complex problem with multiple causes. But among the likely suspects, sugar is high on the list. As sugar consumption has increased, so too has our national waistline.

If youre concerned about protecting your health and your heart, you might want to take a closer look at the sweet stuff in your life.

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Obesity And Other Cardiovascular Risk Factors

Obesity predisposes a person to a number of cardiovascular risk factors, including impaired glucose tolerance and type 2 diabetes, hypertension, dyslipidaemia and sleep apnoea.

There is good evidence of an association between excess body weight and high blood pressure. The age-adjusted prevalence of hypertension in overweight US adults is 22.1% for men with BMI 2527 kg m2, 27% for men with BMI 2730 kg m2, 27.7% for women with BMI 2527 kg m2 and 32.7% for women with BMI 2730 kg m2. These compare with the prevalence of hypertension of approximately 15% in normal weight men and women15. The effect of hypertension together with other deleterious haemodynamic effects on the heart has resulted in an increase in the development of congestive cardiac failure best documented in the Framingham Heart Study. It is of interest that body weight was directly related to the development of CCF independent of other traditional risk factorsReference Hubert, Feinleib, McNamara and Castelli23.