scholarly journals The impact of obesity on cardiovascular disease risk factor

2018 ◽  
Vol 10 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Arun Kumar

Obesity has emerged as the most potential cardiovascular risk factor and has raised concern among public and their health related issues not only in developed but also in developing countries. The Worldwide obesity occurrence has almost has gone three times since 1975. Research suggests there are about 775 million obese people in the World including adult, children, and adolescents. Nearly 50% of the children who are obese and overweight in Asia in are below 5 years. There is a steep incline of childhood obesity when compared to 1971 which is not only in developed countries but also in developing countries. A considerable amount of weight gain occurs during the transition phase from adolescence to young adulthood. It is also suggested that those adultswho were obese in childhood also remained obese in their adulthood with a higher metabolic risk than those who became obese in their adulthood. In India, the urban Indian female in the age group of 30-45 years have emerged as an 〝at risk population” for cardiovascular diseases. To understand how obesity can influence cardiovascular function, it becomes immense important to understand the changes which can take place in adipose tissue due to obesity. There are two proposed concepts explaining the inflammatory status of macrophage. The predominant cause of insulin resistance is obesity. Epidemiological and research studies have indicated that the pathogenesis of obesity-related metabolic dysfunction involves the development of a systemic, low-grade inflammatory state. It is becoming clear that targeting the pro-inflammatory pathwaymay provide a novel therapeutic approach to prevent insulin resistance, particularly in obesity inducedinsulin resistance. Some cost effective interventions that are feasible by all and can be implemented even in low-resource settings includes - population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden. The sixth target in the Global NCD action plan is to reduce the prevalence of hypertension by 25%. Reducing the incidence of hypertension by implementing population-wide policies to educe behavioral risk factors. Reducing cigarette smoking, body weight, blood pressure, blood cholesterol, and blood glucose all have a beneficial impact on major biological cardiovascular risk factors. A variety of lifestyle modifications have been shown, in clinical trials, to lower bloodpressure, includes weight loss, physical activity, moderation of alcohol intake, increased fresh fruit and vegetables and reduced saturated fat in the diet, reduction of dietary sodium intake, andincreased potassium intake. Also, trials of reduction of saturated fat and its partial replacement by unsaturated fats have improved dyslipidaemia and lowered risk of cardiovascular events. This initiative driven by the Ministry of Health and Family Welfare, State Governments, Indian Council of Medical Research and the World Health Organization are remarkable. The Government of India has adopted a national action plan for the prevention and control of non-communicable diseases (NCDs) with specific targets to be achieved by 2025, including a 25% reduction inoverall mortality from cardiovascular diseases, a 25% relative reduction in the prevalence of raised blood pressure and a 30% reduction in salt/sodium intake. In a nutshell increased BMI values can predict the nature of obesity and its aftermaths in terms inflammation and other disease associated with obesity. It’s high time; we must realize it and keep an eye on health status in order to live long and healthy life.

2006 ◽  
Vol 154 (1) ◽  
pp. 131-139 ◽  
Author(s):  
Lenora M Camarate S M Leão ◽  
Mônica Peres C Duarte ◽  
Dalva Margareth B Silva ◽  
Paulo Roberto V Bahia ◽  
Cláudia Medina Coeli ◽  
...  

Background: There has been a growing interest in treating postmenopausal women with androgens. However, hyperandrogenemia in females has been associated with increased risk of cardiovascular disease. Objective: We aimed to assess the effects of androgen replacement on cardiovascular risk factors. Design: Thirty-seven postmenopausal women aged 42–62 years that had undergone hysterectomy were prospectively enrolled in a double-blind protocol to receive, for 12 months, percutaneous estradiol (E2) (1 mg/day) combined with either methyltestosterone (MT) (1.25 mg/day) or placebo. Methods: Along with treatment, we evaluated serum E2, testosterone, sex hormone-binding globulin (SHBG), free androgen index, lipids, fibrinogen, and C-reactive protein; glucose tolerance; insulin resistance; blood pressure; body-mass index; and visceral and subcutaneous abdominal fat mass as assessed by computed tomography. Results: A significant reduction in SHBG (P < 0.001) and increase in free testosterone index (P < 0.05; Repeated measures analysis of variance) were seen in the MT group. Total cholesterol, triglycerides, fibrinogen, and systolic and diastolic blood pressure were significantly lowered to a similar extent by both regimens, but high-density lipoprotein cholesterol decreased only in the androgen group. MT-treated women showed a modest rise in body weight and gained visceral fat mass relative to the other group (P < 0.05), but there were no significant detrimental effects on fasting insulin levels and insulin resistance. Conclusion: This study suggests that the combination of low-dose oral MT and percutaneous E2, for 1 year, does not result in expressive increase of cardiovascular risk factors. This regimen can be recommended for symptomatic postmenopausal women, although it seems prudent to perform baseline and follow-up lipid profile and assessment of body composition, especially in those at high risk of cardiovascular disease.


Author(s):  
Güzin Özden ◽  
Ayşe Esin Kibar Gül ◽  
Eda Mengen ◽  
Ahmet Ucaktürk ◽  
Hazım Alper Gürsu ◽  
...  

Abstract Objectives The objective of this study is to investigate the cardiovascular risk factors associated with metabolic syndrome (MetS), which is increasingly becoming prevalent in childhood obesity. Methods A total of 113 patients, 76 of whom were between the ages of 10 and 17 (mean age: 14.5 ± 1.8 years) and diagnosed with obesity (30 non-MetS and 46 MetS using IDF) and 37 of whom constituted the control group, participated in the study. Echocardiographic examination and atherogenicity parameters (Atherogenic index of plasma [AIP: logTG/HDL], total cholesterol/HDL, and TG/HDL ratio and non-HDL) were evaluated. Results The most common component accompanying obese MetS was found to be hypertension and low HDL. While obesity duration, body mass index (BMI), blood pressure, fasting insulin, insulin resistance, atherogenicity parameters were determined to be significantly higher in the obese-MetS group. Echocardiography showed that while the thickness, volume, and diameter of LV end-diastolic wall, left ventricular mass (LVM), LVM index (LVMI g/m2) and relative wall thickness (RWT) were significantly high in the MetS group, however, mitral E/A ratio was significantly lower (p<0.05). Change in LV geometry consistent with concentric remodeling (increased RWT, normal LVMI) was visible in obese groups. LVM were positively significantly related to BMI, waist circumference, insulin resistance, blood pressure, LDL level, and negative to mitral E/A ratio. In the obese-MetS group, LVMI was positively correlated to office systolic BP, left atrium end-diastolic volume/index. Conclusions LVMI and atherogenicity parameters that were found to be significantly higher in obese MetS exhibit increased cardiovascular risk in childhood.


2017 ◽  
Vol 4 (1) ◽  
pp. 5-8
Author(s):  
T.V. Ashcheulova ◽  
O.A Kochubiei O.A ◽  
T.G. Ovrakh

PREVENTIVE CARDIOLOGY, PRECLINICAL DIAGNOSES: OLD PROBLEMS – NEW APPROACHESAshcheulova T.V., Kochubiei O.A., Ovrakh T.GThe article discusses the new Guidelines on cardiovascular disease prevention in clinical practice (2016) which summarized novel approaches of detection of such risk factors as overweigh, obesity, abdominal obesity, smoking, dyslipidemia (cholesterolemia, triglyceridemia), blood pressure (BP) levels, glucose, insulin, insulin resistance, inflammatory markers, such as c-reactive protein, which can be widely used in practice.KeyWords: Cardiovascular disease, preventive cardiology, risk assessment and stratification, strategy for prevention of cardiovascular diseases. ПРЕВЕНТИВНА КАРДІОЛОГІЯ, ДОКЛІНІЧНА ДІАГНОСТИКА: СТАРІ ПРОБЛЕМИ - НОВІ ПІДХОДИАщеулова Т.В., Кочубєй О.А., Оврах Т.Г. У статті розглядаються нові рекомендації з профілактики серцево-судинних захворювань в клінічній практиці (2016 г.), що узагальнюють нові підходи виявлення таких факторів ризику, як надмірна маса тіла, ожиріння, абдомінальне ожиріння, куріння, дисліпідемія (холестеринемія, тригліцеридемія),  артеріальний тиск (АТ), рівень глюкози, інсуліну, резистентність до інсуліну, запальні маркери, такі як С-реактивний білок, які можуть знайти широке застосування у практичній охороні здоров’я.Ключові слова: Серцево-судинні захворювання, профілактична кардіологія, оцінка і стратифікація ризику, стратегія профілактики серцево-судинних захворювань. ПРЕВЕНТИВНАЯ КАРДИОЛОГИЯ, ДОКЛИНИЧЕСКАЯ ДИАГНОСТИКА: СТАРЫЕ ПРОБЛЕМЫ - НОВЫЕ ПОДХОДЫАщеулова Т.В., Кочубей О.А., Оврах Т.Г. В статье рассматриваются новые рекомендации по профилактике сердечно-сосудистых заболеваний в клинической практике (2016 г.), обобщены новые подходы выявления таких факторов риска, как избыточная масса тела, ожирение, абдоминальное ожирение, курение, дислипидемия (холестеринемия, гипертриглицеридемия), повышение артериального давления, уровень глюкозы, инсулина, резистентность к инсулину, маркеры воспаления, такие как С-реактивный белок, которые могут найти широкое применение в практическом здравоохранении.Ключевые слова: сердечно-сосудистые заболевания, профилактическая кардиология, оценка и стратификация риска, стратегия профилактики сердечно-сосудистых заболеваний. 


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Michelle C Odden ◽  
Andreea Rawlings ◽  
Alice Arnold ◽  
Mary Cushman ◽  
Mary Lou Biggs ◽  
...  

Introduction: Cardiovascular disease is the leading cause of mortality in old age, yet there is limited research on the patterns of cardiovascular risk factors that predict survival to 90 years. Hypothesis: The patterns of cardiovascular risk factors that portend longevity will differ from those that confer low cardiovascular risk. Methods: We examined repeated measures of blood pressure, LDL-cholesterol, and BMI from age 67 and survival to 90 years in the Cardiovascular Health Study (CHS). CHS is a prospective study of 5,888 black and white adults in two waves (1989-90 and 1992-93) from Medicare eligibility lists in four counties in the U.S. We restricted to participants aged 67 to 75 years at baseline to control for birth cohort effects and examined repeated measures of cardiovascular risk factors throughout the late-life course. We fit logistic regression models to predict survival to age 90 using generalized estimating equations, and modeled the risk factors as linear, a linear spline, and clinically relevant categories. Models were adjusted for demographics and medication use, and we also examined whether the association of each risk factor with longevity varied by the age of risk factor measurement. Best fit models are presented. Results: Among 3,645 participants in the birth cohort, 1,160 (31.8%) survived to 90 by June 16 th , 2015. Higher systolic blood pressure in early old age was associated with reduced odds for longevity, but there was an interaction with age such that the association crossed the null at 80 years. (Table) Among those with LDL-cholesterol <130 mg/dL, higher LDL-cholesterol was associated with greater longevity; at levels above 130 mg/dL there was no association between LDL-cholesterol and longevity. BMI had a u-shaped association with longevity. Conclusions: In summary, the patterns of risk factors that predict longevity differ from that considered to predict low cardiovascular risk. The risk of high systolic blood pressure appears to depend on the age of blood pressure measurement.


Heart ◽  
2019 ◽  
Vol 105 (16) ◽  
pp. 1273-1278 ◽  
Author(s):  
Laura Benschop ◽  
Johannes J Duvekot ◽  
Jeanine E Roeters van Lennep

Hypertensive disorders of pregnancy (HDP), such as gestational hypertension and pre-eclampsia, affect up to 10% of all pregnancies. These women have on average a twofold higher risk to develop cardiovascular disease (CVD) later in life as compared with women with normotensive pregnancies. This increased risk might result from an underlying predisposition to CVD, HDP itself or a combination of both. After pregnancy women with HDP show an increased risk of classical cardiovascular risk factors including chronic hypertension, renal dysfunction, dyslipidemia, diabetes and subclinical atherosclerosis. The prevalence and onset of cardiovascular risk factors depends on the severity of the HDP and the coexistence of other pregnancy complications. At present, guidelines addressing postpartum cardiovascular risk assessment for women with HDP show a wide variation in their recommendations. This makes cardiovascular follow-up of women with a previous HDP confusing and non-coherent. Some guidelines advise to initiate cardiovascular follow-up (blood pressure, weight and lifestyle assessment) 6–8 weeks after pregnancy, whereas others recommend to start 6–12 months after pregnancy. Concurrent blood pressure monitoring, lipid and glucose assessment is recommended to be repeated annually to every 5 years until the age of 50 years when women will qualify for cardiovascular risk assessment according to all international cardiovascular prevention guidelines.


1999 ◽  
Vol 96 (5) ◽  
pp. 513-523 ◽  
Author(s):  
Robert C. ANDREWS ◽  
Brian R. WALKER

Insulin resistance has been proposed as a mediator of the association between risk factors for cardiovascular disease in the population. The clinical syndrome of glucocorticoid excess (Cushing's syndrome) is associated with glucose intolerance, obesity and hypertension. By opposing the actions of insulin, glucocorticoids could contribute to insulin resistance and its association with other cardiovascular risk factors. In this review, we describe briefly the known mechanisms of insulin resistance and highlight the potential mechanisms for the effect of glucocorticoids. We then discuss factors which modulate the influence of glucocorticoids on insulin sensitivity; this highlights a novel therapeutic strategy to manipulate glucocorticoid action which may prove to be a useful tool in treating subjects with insulin resistance. Finally, we describe evidence from human studies that glucocorticoids make an important contribution to the pathophysiology of insulin resistance in the population.


Cholesterol ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Vincenzo Capuano ◽  
Norman Lamaida ◽  
Ernesto Capuano ◽  
Rocco Capuano ◽  
Eduardo Capuano ◽  
...  

The aim of this study was to determine the trends of cardiovascular risk factor prevalence between 1988/9 and 2008/9 in the 25–74-year-old population in an area of Southern Italy. We compared three cross-sectional studies conducted in random population samples, in 1988/9, 1998/9, and 2008/9 in Salerno, Italy. The methodology of data collection (lipid profile, systolic and diastolic blood pressure, glycaemia, and smoking) and conducting tests which the population underwent during the three phases was standardized and comparable. Prevalence of diabetes, hypertension, hypercholesterolemia, and smoking was calculated and standardized for age. A total of 3491 subjects were included. From 1988/9 to 2008/9, in males, the prevalence of all four risk factors was reduced. In women, there was a clear reduction of hypertension, a similar prevalence of hypercholesterolemia, and an increase of smoking and diabetes. In the area of Salerno, our data confirm that the global prevalence of the major risk factors is decreasing in men, but their absolute values are still far from optimization. In women, diabetes and smoking showed a negative trend, therefore requiring targeted interventions. These data are now used as a base for executive targeted programs to improve prevention of cardiovascular disease in our community.


2013 ◽  
Vol 12 (3) ◽  
pp. 40-42
Author(s):  
N. A. Koryagina ◽  
I. N. Ryamzina ◽  
A. I. Shaposhnikova ◽  
E. N. Koltyrina

Aim. To assess the prevalence of major risk factors (RFs) of cardiovascular disease (CVD) in a young working population.Material and methods. This cross-sectional study included 1832 respondents (70% men and 30% women; mean age 29,44±8,6 years). The levels of blood pressure (BP), total cholesterol (TCH), and body mass index (BMI), as well as the prevalence of smoking, were assessed.Results. Elevated office BP levels were registered in 10,5%, and isolated ambulatory arterial hypertension (AH) in 10%. Overall, AH prevalence in this young working population was 20%. Elevated BP was registered in 34,2% of individuals with hypercholesterolemia (TCH >5 mmol/l), compared to 18,2% in people with TCH <5 mmol/l (p<0,001).Conclusion. The most prevalent CVD RFs in working people under 40 were obesity and AH.


2021 ◽  
Author(s):  
David S. Krantz ◽  
Lisa M. Shank ◽  
Jeffrey L. Goodie

Evidence indicates that post-traumatic stress disorder (PTSD) is a significant risk factor for the development and progression of cardiovascular disease (CVD). Most explanations for PTSD-CVD associations conceptualize PTSD as a stress-related mental health disorder that elicits physiological, behavioral, and psychological responses that are causal factors in the development of cardiovascular disorders. This article reviews evidence for the broader physical health consequences of PTSD, and presents a conceptual model based on research suggesting that PTSD is a systemic disorder. Specifically, research findings indicate that diagnostic criteria are just the “tip of the iceberg” of a broader systemic disorder with elements that are cardiovascular risk factors. These systemic physiological and behavioral elements therefore should not be regarded as accompanying but unrelated diseases or comorbidities, but as inherent components of PTSD that directly impact the development of CVD. The systemic disorder approach has implications for the conceptualization of PTSD as a cardiovascular risk factor, needed research on PTSD and CVD, and clinical efforts to reduce PTSD-associated cardiovascular risk. It is suggested that treatments that aim to reduce cardiovascular disease risk need to address both the PTSD diagnostic components and its associated cardiovascular risk factors. Further research is needed to test the applicability and implications of the systemic disorder perspective.


2020 ◽  
Vol 26 (2) ◽  
pp. 163-169
Author(s):  
V. I. Shcherbakov ◽  
Ya. V. Polonskaya ◽  
E. V. Kashtanova ◽  
A. V. Shirinskaya

Preeclampsia (PE) is one of the most common and serious complications of pregnancy. In women with a history of PE the risk of cardiovascular disease is increased, and atherosclerosis can be induced even during fetal development. The exact mechanisms by which PE increases future cardiovascular risk are unknown, although multiple similarities between mechanisms responsible for cardiovascular disease and PE are reported. Risk factors for PE, such as obesity, insulin resistance, thrombophilia, changes in the lipid spectrum are similar to those for atherosclerosis, which allows us to compare these two conditions to clarify the specifics and is important for understanding the pathogenesis of both pathologies. PE, as well as atherosclerosis, manifests as endothelial dysfunction, abnormal immune function, oxidative stress, activation of inflammation, changes in lipid metabolism. Recent studies have provided a broader understanding of the problem, although there are still many open questions. The etiology and pathogenesis of these diseases, their possible relationship are not fully understood. The article provides a summary of possible common mechanisms of PE and atherosclerosis.


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