Obesity Paradox in Cardiovascular Disease

Abstract

Obesity is closely associated with comorbid diseases such as arterial hypertension, coronary heart disease, heart failure, cardiac arrhythmias, and other pathologies. Obesity-related cardiovascular diseases have a negative impact on the quality and life expectancy of patients. At the same time, many researchers have noted a better prognosis for cardiovascular events and overall mortality in overweight and obese subjects compared to people with normal weight or reduced body weight. This clinical situation is called the obesity paradox. The obesity paradox was demonstrated by the results of a number of studies that assessed the dependence of the risk of mortality and other adverse clinical outcomes on the value of body mass index in patients with various cardiovascular diseases. The body mass index has limited information value, as it does not reflect the composition of the body and the distribution of adipose tissue. However, cardiometabolic risk is determined mainly by the amount of visceral adipose tissue. On the other hand, the value of the body mass index depends not only on the content of adipose tissue, but also on the amount of muscle mass in the human body. In turn, the functional state of patients, in particular, cardiorespiratory fitness, depends on the size of muscle mass. Further studies evaluating the body composition and functional parameters of patients are needed to elucidate the cause of the obesity paradox.