Journal
CURRENT OPINION IN CARDIOLOGY
Volume 21, Issue 4, Pages 353-360Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.hco.0000231406.84554.96
Keywords
body mass index; cardiovascular disease; cardiovascular mortality; metabolic syndrome; obesity
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Purpose of review Obesity has reached global epidemic proportions because of an increasingly obesogenic environment. This review examines the association between obesity, and in particular visceral fat, as a risk factor for cardiovascular disease and mortality. Recent findings The World Health Organization defines obesity based on the body mass index. Recently the waist-to-hip ratio has been shown to be a significantly stronger predictor of cardiovascular events than body mass index. The metabolic syndrome and its evolving definition represent a cluster of metabolic risk factors which help predict cardiovascular disease and mortality. Although insulin resistance plays a central role in the pathophysiology of the metabolic syndrome, there is limited support for therapy with insulin sensitizers, thiazolidinediones, in patients with coronary artery disease. The current anti-obesity drugs, orlistat and sibutramine, have only a modest effect on weight loss. The blockade of the endocannabinoid system with rimonabant, however, may be a promising: new strategy. Summary Obesity is associated with significant increase in cardiovascular risk. Lifestyle modification remains the cornerstone of management although anti-obesity medications may be,indicated in high risk individuals with comorbid disease.
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