Obesity is defined as a BMI ( a ratio of weight to height) of 30 or higher.
For many years, it was believed that heart disease was a result of the strain put on the heart by a severely overweight body, but that was simplistic. Heart specialists also thought that type 2 diabetes & high blood pressure were the mechanisms that damaged the heart. We are now discovering that the state of being obese, in and of itself, can lead to cardiovascular dysfunction and heart failure.
New England Journal of Medicine published a study in 2002 that showed that excess body weight increased the risk of heart failure, without even considering diabetes or hypertension as risk factors. Obesity can cause thickening of wall of the heart’s left venticle– a condition called left venticle hypertrophy — that can cause heart failure. We also know that excess abdominal fat signals the liver to produce high levels of the “bad” cholesterol that can block arteries and provoke heart attack causing blood clots.
A 2004 study found that the hearts of severely obese people had a reduced ability to pump blood and refill with blood between heartbeats. They also found a smaller but significant dysfunction in the mildly obese subjects, the likely cause: inflammation caused by metabolic changes.
Obesity causes prolonged inflammation of heart tissue
Inflammation of blood vessel walls boosts heart failure risk, Other results of this study revealed that obese people are more likely to have a higher level of immune system proteins such as interleukin 6, C-reactive protein and fibrinogen. At normal levels, these proteins are beneficial aspects of the immune system that cause inflammation to help wound healing; But at chronically high levels, they can cause serious damage to the cardiovascular system. In fact, doubling interleuken 6 levels alone increased heart failure risk by 84%.
“The biological effects of obesity on the heart is profound” says Dr. Jao Lima, professor of medicine and radiology at the John Hopkins School of Medicine. “Even if obese people feel otherwise healthy, there are measurable and early chemical signs of damage to their hearts, beyond the well-known implications for diabetes and high blood pressure.”
The Metabolic Syndrome
Typically diagnosed when a patient has low “good” cholesterol, high “bad: cholesterol, high tryglycerides, high blood pressure and insulin resistance. Obesity can trigger every one of these conditions. The Metabolic Syndrome is the “perfect storm” of cardiovascular dysfunction risk because it can attack the heart and blood vessels from so many directions: coating arterial walls with sticky plaques, increasing inflammation that damages blood vessels, damaging the cardiovascular system by raising blood pressure and causing abnormalties in the heart.
The greatest long term concern with obesity. “Insulin resistance is probably one of the big mechanisms that causes people to get diabetes. We’ve learned now that people who have too many fat cells…those cells are releasing a lot of chemicals that make the body resistant to insulin. it makes the body pump out more and more insulin to take the blood sugar out of the muscle. Eventually, the pancreas burns out and people get diabetes.”, says cardiologist, Dr. Joseph Johns.
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