Top Things to Know: Obesity and Cardiovascular Disease
Published: April 22, 2021
- This AHA scientific statement summarizes new insights into the impact of obesity on the diagnosis, treatment, and outcomes in atherosclerotic cardiovascular disease, heart failure and arrhythmias.
- The obesity epidemic contributes to the global burden of cardiovascular disease.
- Abdominal obesity and visceral adiposity have been linked to cardiovascular disease risk independent of body mass index.
- Lifestyle interventions with subsequent weight loss improve cardiovascular risk factors but have not been shown to reduce coronary artery disease events.
- Bariatric surgery for weight loss treatment is associated with a reduction in coronary artery disease risk.
- Non-invasive and invasive diagnostic tools for coronary artery disease have important strengths and limitations to consider in patients with obesity.
- There are instances where survival rates are higher and outcomes are better in people who are overweight or have Class I obesity, known as the Obesity Paradox.
- Patients who are overweight or with Class I obesity have better clinical outcomes than do leaner patients with similar degrees of heart failure (HF). The etiology of this obesity paradox for cardiovascular outcomes remains unclear.
- There is a clear benefit of weight loss for patients with obesity and atrial fibrillation, with lower rates of atrial fibrillation with weight loss.
- This statement also identifies areas for future research on the role of lifestyle interventions and therapeutics for obesity in patients with coronary artery disease, heart failure, and arrhythmias.
Citation
Powell-Wiley TM, Poirier P, Burke LE, Despres J-P, Gordon-Larsen P, Lavie CJ, Lear SA, Ndumele CE, Neeland IJ, Sanders P, St-Onge M-P; on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. Obesity and cardiovascular disease: a scientific statement from the American Heart Association [published online ahead of print April 22, 2021]. Circulation. doi: 10.1161/CIR.0000000000000973