The Obesity Paradox in Heart Failure: What Is Real Obesity in Heart Failure?
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OBESITY + DIET (G. RAO, SECTION EDITOR)
The Obesity Paradox in Heart Failure: What Is Real Obesity in Heart Failure? Hong Seok Lee 1 & Ferdinand Visco 2 & Savi Mushiyev 2 & Gerald Pekler 2 & Amrut Savadkar 1 & Eder Hans Cativo 1 & Hans Alexi Reyes Garay 1
# Springer Science+Business Media New York 2016
Abstract The obesity is a conventional cardiovascular risk factor. Obesity has detrimental effects on heart failure, but has been found to be paradoxically associated with improved survival. The obesity paradox remains controversial in the literatures. There are various underlying mechanisms to explain the obesity paradox in heart failure. Epidemiologic, biochemical, animal studies revealed this unexpected phenomenon, which was described as an obesity paradox. BMI does not provide information body composition and cardiopulmonary fitness status, which can be related to obesity paradox. Still, the obesity paradox is controversial; therefore, intentional weight gaining may not be recommended. Many researches related to obesity paradox have been introduced and further research needs to be done in the future. Keywords Obesity paradox . Heart failure . Cardiovascular risk factors
problem globally [3]. Obesity is associated with many comorbidities, including coronary artery disease, congestive heart failure (CHF), stroke, hypertension, diabetes mellitus, obstructive sleep apnea and sleep-disordered breathing, and cancer [4, 5]. It affects a significant consequence on health and morbidity; however, within the last decade, mortality in obese heart failure (HF) patients has been seen to be lower in comparison with normal weight persons [6–8]. There is a concept of obesity paradox which means obese persons have a lower risk of mortality or better survival. Obesity was reported as a risk factor for cardiovascular mortality; however, it has been remained paradoxically cardioprotective in some population. Although there is increasing BMI (body mass index) in general population, patients with heart failure and coronary artery disease were less likely to have acute myocardial infarction or stroke [10, 21]. This paper reviews obesity paradox as well as the conventional consequences of obesity effects affecting on cardiovascular disease.
Introduction Obesity has been increased over decades in the USA compared to few years ago [1, 2], and it has now become a critical
This article is part of the Topical Collection on Obesity + Diet
Clinical Consequences of Obesity Conventionally, obesity paradox has been reported to be related to major adverse complication such as increase of insulin resistance, hypertension, dyslipidemia, abnormal left ventricular dysfunction, heart failure, coronary artery disease, obstructive sleep apnea, osteoarthritis, and cancer [5, 9, 10, 11•, 12].
* Hong Seok Lee [email protected]
Cardiac Consequences of Obesity 1
Department of Medicine, Metropolitan Hospital, New York Medical College, 1901 1st Ave, New York, NY 10029, USA
2
Division of Cardiology, Department of Medicine, Metropolitan Hospital, New Y
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