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Rethinking weight loss treatments as cardiovascular medicine in obesity, a comprehensive review

医学 肥胖 重症监护医学 超重 疾病 冠状动脉疾病 人口 心力衰竭 生物信息学 内科学 环境卫生 生物
作者
Dario Tuccinardi,Mikiko Watanabe,Davide Masi,Lavinia De Monte,Luigi Bonifazi Meffe,Ilaria Cavallari,Annunziata Nusca,Ernesto Maddaloni,Lucio Gnessi,Nicola Napoli,Silvia Manfrini,Francesco Grigioni
出处
期刊:European Journal of Preventive Cardiology [Oxford University Press]
卷期号:31 (10): 1260-1273 被引量:4
标识
DOI:10.1093/eurjpc/zwae171
摘要

Abstract The global escalation of obesity has made it a worldwide health concern, notably as a leading risk factor for cardiovascular disease (CVD). Extensive evidence corroborates its association with a range of cardiac complications, including coronary artery disease, heart failure, and heightened vulnerability to sudden cardiac events. Additionally, obesity contributes to the emergence of other cardiovascular risk factors including dyslipidaemia, type 2 diabetes, hypertension, and sleep disorders, further amplifying the predisposition to CVD. To adequately address CVD in patients with obesity, it is crucial to first understand the pathophysiology underlying this link. We herein explore these intricate mechanisms, including adipose tissue dysfunction, chronic inflammation, immune system dysregulation, and alterations in the gut microbiome.Recent guidelines from the European Society of Cardiology underscore the pivotal role of diagnosing and treating obesity to prevent CVD. However, the intricate relationship between obesity and CVD poses significant challenges in clinical practice: the presence of obesity can impede accurate CVD diagnosis while optimizing the effectiveness of pharmacological treatments or cardiac procedures requires meticulous adjustment, and it is crucial that cardiologists acknowledge the implications of excessive weight while striving to enhance outcomes for the vulnerable population affected by obesity. We, therefore, sought to overcome controversial aspects in the clinical management of heart disease in patients with overweight/obesity and present evidence on cardiometabolic outcomes associated with currently available weight management interventions, with the objective of equipping clinicians with an evidence-based approach to recognize and address CVD risks associated with obesity.
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