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Complications of cardiovascular disease for obesity
Complications of cardiovascular disease for obesity
Coronary heart disease (CHD) Patients with predominantly abdominal (intra-) form of obesity, and those with marked increase in body weight at a young age are at greater risk for coronary heart disease (CHD). CHD risk begins to rise, even at "normal" body mass index (BMI) (23 kg/m2 in men and 22 kg/m2 for women). And the presence of abdominal obesity increases the risk of coronary heart disease for any value of BMI.
Indeed, the study Nurse Health Study found that women with lower BMI but a large value of the ratio of waist circumference to hip circumference, the risk of myocardial infarction (including fatal) was higher than in women with high BMI but a smaller value of the ratio of waist circumference to hip circumference. Weight gain of 5 kg or more after 18 years of age also increases the risk of myocardial infarction.
A large role in increasing the frequency of CHD in obesity are risk factors such as hypertension, dyslipidemia, changes in glucose tolerance or diabetes, and metabolic syndrome. In epidemiological studies difficult to study the effect of the obesity on CHD risk, possibly because it takes a long time to monitor patients, to identify the role of other risk factors affecting the change in body weight (eg, smoking), and to study the effect of type of fat distribution. However, several epidemiological studies have long shown that overweight and obesity increase the risk of CHD even after adjustment of other known risk factors. In this connection, the American Heart Association recently included in the obesity list of major risk factors for coronary heart disease and developed recommendations for the normalization of weight.
Cerebrovascular and thromboembolic complications in both women and men overweight and obesity increase the risk of ischemic stroke. The risk of stroke (including fatal) in patients with obesity progressively increases with increasing values of body mass index (BMI) and almost two times higher than in lean people. Obesity, especially abdominal obesity, increases the risk of venous stasis, deep venous thrombosis and embolism (blockage of detached thrombus), the pulmonary artery.
Lower limb venous disease may develop due to increased intra-abdominal pressure and pathology of blood coagulation, as well as increased release of inflammatory mediators (biologically active substances accompanying inflammation) in the abdominal (intraperitoneal) obesity. Recent studies have shown that elderly patients with a BMI of 25 kg/m2 or more, after undergoing hip replacement surgery, the risk of subsequent hospitalization for thromboembolism (deep vein thrombosis or pulmonary embolism) was 2.5 times greater.
Arterial hypertension (AH) The relationship between the value of body mass index (BMI) and the occurrence of hypertension has been confirmed in large-scale epidemiological studies. Data from these studies demonstrated that (with age) the prevalence of hypertension among men and women who are obese, 2.5 times higher (38% and 42% respectively) than in lean men (15% among both men and women .) A significant risk factor for hypertension is also abdominal (intraperitoneal) type of obesity, several studies have indicated that may be even more important than BMI. In Framingham Study found that increased blood pressure by 6.5 mm Hg. of Art. for every 10% increase in body weight.
