Abstract
Current statistics on global obesity are staggering. In 2002, the International Obesity Task Force estimated that worldwide, nearly 1 billion (6%) people were overweight or obese. The American Heart Association's 2002: "Top 10" Research Advances for the Treatment of Heart Disease include obesity as a strong and independent risk factor for developing heart failure. This article outlines national and world statistics, cardiac risk factors, and pathophysiologic theories outlining the cellular mechanisms that associate obesity and heart failure. Access to guidelines for effective screening, evaluation, and treatment of obesity are also provided.
While research has shown an association between extreme obesity and heart failure 1,2 only recently have overweight and lesser degrees of obesity been shown to be strongly and independently linked to an increased risk of heart failure. 3 In 2002, Kenchaiah et al examined the relationship between overweight and lesser degrees of obesity on the risk of developing heart failure in 5881 participants in the Framingham Heart Study. Heart failure developed in a total of 496 (8%) subjects (258 women and 238 men). After adjustment for known risk factors, over-weight women body mass index (BMI) 25.0-29.9) had a 50% greater risk of heart failure, and obese women (BMI >= 30.0) were twice as likely to develop heart failure compared with normal weight individuals. Overweight men had a 20% increase in heart failure risk, whereas obese men had a 90% higher increased risk. With each increase of 1 unit of BMI, a woman's risk of heart failure increased 7% and a man's risk of heart failure increased 5%. More important, obesity alone was estimated to account for 14% of heart failure cases in women and 11% of heart failure cases in men. 4
The American Heart Association's 2002 "Top 10" Research Advances for the treatment of heart disease includes obesity as a strong and independent risk factor for developing heart failure. This article will review both national and world statistics, cardiac risk factors, and the pathophysiologic theories outlining the cellular mechanisms that associate obesity and heart failure. Access to guidelines for effective screening, evaluation, and treatment of obesity are also provided.