Impact of Obesity on Cardiovascular diseases

Obesity and Diet

The role of diet is crucial in the development and prevention of cardiovascular disease and is the key modifiable risk factor for heart diseases. The obesity is an epidemic which is spreading from low- to the middle-income countries as a result of new dietary habits and sedentary ways of life, fuelling chronic diseases and premature mortality.

This sneaky inflammation and the inflammatory factors when released increase the risk of developing atherosclerosis and the build-up of plaque in the walls of the arteries. Obesity also releases substances in the blood that can make plaque rupture, which then leads to heart attacks. The extra weight carrying does put the heart under increased stress, in particular during the relaxation phase of the cardiac cycle, which is known as the diastole. As the heart fills with blood, there’s higher pressure in the heart valves, which with over time, can lead to causing people to have heart failure symptoms.

Association between Obesity and Cardiovascular outcomes

As Obesity increases there are adverse cardiac events occurring in many ways, which may be indirectly mediated through risk factors associated with metabolic syndrome like diabetes, dyslipidemia, glucose intolerance, hypertension, and or effects from sleep disorders associated with obesity.  Metabolic syndrome is associated with central or abdominal obesity, which is associated with the distribution of fat predominantly in the abdominal viscera rather than the extremities in the body. Waist circumference or waist-hip ratio is useful ways of assessing this type of fat distribution and increased values confer additional cardiovascular risk. In abdominal obesity, there is an increase in the level of various inflammatory markers along with the occurrence of a prothrombotic state. The Obese patients have increased concentrations of many adipokines and other chemical mediators like interleukin-6, resistin, plasminogen activator inhibitor-1, tumor necrosis factor-alpha, retinol binding protein, acylation stimulating protein, lipoprotein lipase, cholesteryl ester transport protein, estrogens, leptin, angiotensinogen, and insulin-like growth factor-1, but these proteins have various adverse effects on the cardiovascular system by creating a pro-inflammatory and prothrombotic state as well as causing endothelial damage and vascular hypertrophy. There is also a higher incidence of sleep apnea/hypoventilation syndromes in obesity, which can also affect the heart in different ways.

Obesity also poses considerable challenges in making a precise cardiovascular diagnosis because of limitations in the physical examination as well as with various investigations like imaging studies, electrocardiograms (ECGs), and cardiac catheterization.

The direct effect of Obesity on the heart in obese individual results in cardiomyopathy which is also known as the adipositas cordis. Initially, it increases the fat content of the heart because of a metaplastic phenomenon and is not an infiltrative process. The various tissues of the heart, like the atrioventricular node, sinus node, right bundle branch, and the myocardium near the atrioventricular ring, are replaced by fat cells. The conduction defects can occasionally occur in the sinoatrial block, bundle branch block, and, rarely, an atrioventricular block which results in irregular bands of adipose tissue which may separate and cause pressure-induced atrophy in the myocardial cells. These adipose cells surrounding the heart valves may also secrete active molecules like adipokines, which indirectly cause injurious effects on the adjacent myocardial cells or the heart cells. Accumulation of triglycerides in nonfat cells like myocytes can also directly cause cell dysfunction due to lipotoxicity.

Heart Disease and Obesity Treatment

In addition to weight loss, the sodium restriction may be helpful in the treatment of heart disease, since high intake of sodium increases fluid retention in the body. There a number of series of medically supervised weight loss programs, starting from alterations in dietary and physical habits to pre-packed meals, pharmacotherapy and weight loss surgery, which can be used to make an impact on both cardiovascular diseases and obesity.