Cardiovascular Prevention in Obese Patients

被引:6
作者
Landecho, Manuel F. [1 ]
Moncada, Rafael [2 ,3 ,4 ]
Valenti, V-Ctor [2 ,3 ,5 ]
Fruhbeck, Gema [2 ,3 ,6 ,7 ]
机构
[1] Clin Univ Navarra, TRUEHF Inst Invest Sanitaria Navarra IdiSNA, Dept Internal Med, Pamplona, Spain
[2] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBEROBN, Pamplona, Spain
[3] Inst Invest Sanitaria Navarra IdiSNA, Obes & Adipobiol Grp, Pamplona, Spain
[4] Univ Navarra Clin, Dept Anesthesia, Pamplona, Spain
[5] Univ Navarra Clin, Dept Surg, Pamplona, Spain
[6] Univ Navarra Clin, Dept Endocrinol & Nutr, Avda Pio 12,36, Pamplona 31008, Spain
[7] Univ Navarra, Metab Res Lab, Pamplona, Spain
关键词
Obesity; treatment; lifestyle intervention; physical activity; prevention; paradox; BODY-MASS INDEX; ENDOBARRIER GASTROINTESTINAL LINER; CARDIOMETABOLIC RISK-FACTORS; METABOLICALLY HEALTHY OBESE; TYPE-2; DIABETES-MELLITUS; PLACEBO-CONTROLLED TRIAL; EASO POSITION STATEMENT; HUMAN ADIPOSE-TISSUE; WEIGHT-LOSS; BARIATRIC SURGERY;
D O I
10.2174/1381612822666160822125834
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Background: The World Health Organization has emphasized that an increased body mass index (BMI) is a major risk factor for non-communicable diseases (NCDs) such as cardiovascular disease (CVD) together with diabetes, musculoskeletal disorders and some cancers. The American Heart Association had already identified obesity as an independent risk factor in 1995. There is a significantly increased risk of CVD independently of other traditional risk factors (age, sex, physical activity, smoking, blood pressure and cholesterol levels) for patients fulfilling BMI criteria of moderate overweight, which increases with the diagnosis of obesity. Thus, both overweight and obesity are major risk factors for type 2 diabetes (T2D), hypertension, and atherogenic dyslipidemia, among others. These diseases, when clustered, form the metabolic syndrome, a condition with exponential risk for CVD as compared with its isolated components. In this scenario, obesity emerges as a major public health challenge due to its huge clinical implications, taxing not only individuals but also health-care systems and society at large. Methods: The present review focuses on: i) the link between dysfunctional fat excess and CVD; ii) the apparent controversies surrounding the obesity paradox as well as the concept of metabolically healthy obesity; iii) the known beneficial effects following weight loss; and iv) available strategies to treat obesity in order to ameliorate cardiovascular risk, which include lifestyle interventions, drug therapy, endoscopic and surgical procedures. Conclusion: Obesity is a highly heterogeneous disease that requires customized recommendations. Weight loss in different degrees is attainable via diverse procedures reducing morbidity and mortality while improving psychological well-being and social function. Therapeutic strategies should be tailored to the patient's characteristics and need a long-term personal commitment to change.
引用
收藏
页码:5687 / 5697
页数:11
相关论文
共 97 条
[1]   Intragastric balloon for obesity treatment: results of a multicentric evaluation for balloons left in place for more than 6 months [J].
Alfredo, Genco ;
Roberta, Maselli ;
Francesca, Frangella ;
Massimiliano, Cipriano ;
Pietro, Forestieri ;
Daniela, Delle Piane ;
Francesco, Furbetta ;
Giancarlo, Micheletto ;
Franco, Ciampaglia ;
Paola, Granelli ;
Maurizio, Zilli ;
Michele, Lorenzo ;
Giorgio, Di Rocco ;
Domenico, Giannotti ;
Adriano, Redler .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2015, 29 (08) :2339-2343
[2]   Controlled-Release Phentermine/Topiramate in Severely Obese Adults: A Randomized Controlled Trial (EQUIP) [J].
Allison, David B. ;
Gadde, Kishore M. ;
Garvey, William Timothy ;
Peterson, Craig A. ;
Schwiers, Michael L. ;
Najarian, Thomas ;
Tam, Peter Y. ;
Troupin, Barbara ;
Day, Wesley W. .
OBESITY, 2012, 20 (02) :330-342
[3]   Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System A Report From the Workshop Convened by the World Heart Federation [J].
Anand, Sonia S. ;
Hawkes, Corinna ;
de Souza, Russell J. ;
Mente, Andrew ;
Dehghan, Mahshid ;
Nugent, Rachel ;
Zulyniak, Michael A. ;
Weis, Tony ;
Bernstein, Adam M. ;
Krauss, Ronald M. ;
Kromhout, Daan ;
Jenkins, David J. A. ;
Malik, Vasanti ;
Martinez-Gonzalez, Miguel A. ;
Mozaffarian, Dariush ;
Yusuf, Salim ;
Willett, Walter C. ;
Popkin, Barry M. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2015, 66 (14) :1590-1614
[4]   Bariatric Surgery Worldwide 2013 [J].
Angrisani, L. ;
Santonicola, A. ;
Iovino, P. ;
Formisano, G. ;
Buchwald, H. ;
Scopinaro, N. .
OBESITY SURGERY, 2015, 25 (10) :1822-1832
[5]  
[Anonymous], CAN MED ASSOC J
[6]  
[Anonymous], 2012, INT J OBESITY, DOI DOI 10.1038/ijo.2011.247
[7]  
[Anonymous], N ENGL J MED
[8]   Naltrexone/bupropion for the treatment of obesity and obesity with Type 2 diabetes [J].
Apovian, Caroline M. .
FUTURE CARDIOLOGY, 2016, 12 (02) :129-138
[9]   The 2013 American Heart Association/American College of Cardiology/The Obesity Society Guideline for the Management of Overweight and Obesity in Adults What Is New About Diet, Drugs, and Surgery for Obesity? [J].
Apovian, Caroline M. ;
Aronne, Louis J. .
CIRCULATION, 2015, 132 (16) :1586-1591
[10]   Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline [J].
Apovian, Caroline M ;
Aronne, Louis J. ;
Bessesen, Daniel H. ;
McDonnell, Marie E. ;
Murad, M. Hassan ;
Pagotto, Uberto ;
Ryan, Donna H. ;
Still, Christopher D. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2015, 100 (02) :342-362