Cited by 588Adipokines, Inflammation, and Metabolic DiseasesDiabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Disease and Adiposity

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Obesity as a cardiovascular risk factor

Sowers, James R·2003·The American Journal of Medicine

DOI 10.1016/j.amjmed.2003.08.012

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Abstract

The prevalence of overweight and obesity continues to increase rapidly in the United States, with more than half of all adults currently overweight or obese. In general, people become obese because of a combination of inherited genes and a lifestyle consisting of low levels of physical activity and consumption of excess calories. Obesity, especially the central or visceral type, is a predisposing factor for the development of type 2 diabetes mellitus, hypertension, and cardiovascular disease (CVD). Obesity and type 2 diabetes are associated with insulin resistance. The relation among obesity, insulin resistance, and CVD appears to develop at a relatively young age. Central obesity is linked with hyperinsulinemia, insulin resistance, dyslipidemia, and proinflammatory and prothrombotic clinical states. Adipose tissue synthesizes and secretes biologically active molecules that may affect CVD risk factors. These chemical messengers include adiponectin, resistin, leptin, plasminogen activator inhibitor-1, tumor necrosis factor-alpha, and interleukin-6. In overweight and obese individuals, weight loss may improve insulin sensitivity, leading to reduction in risk factors for CVD and, consequently, the potential for cardiovascular events. Agents that improve insulin sensitivity, such as the thiazolidinediones, have been shown to reduce visceral obesity. Decreases in visceral adipose tissue contribute to improvements in insulin sensitivity and blood pressure, and weight loss reduces serum levels of triglycerides and low-density lipoprotein cholesterol while increasing serum levels of high-density lipoprotein cholesterol. Reduction of risk factors suggests that the development of cardiovascular disease will be reduced by the improvement of insulin sensitivity and weight loss.

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Association between Metabolite Profiles, Metabolic Syndrome and Obesity Status
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Background
Paradigm shift – Metabolic transformation of docosahexaenoic and eicosapentaenoic acids to bioactives exemplify the promise of fatty acid drug discovery
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“Obesity is a significant risk factor for a range of diseases from diabetes, cardiovascular disease to cancer (Sowers, 2003).”
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Chromium ( d ‐Phenylalanine)3 Improves Obesity‐Induced Cardiac Contractile Defect in ob/ob Mice
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Heart energy metabolism impairment in Western-diet induced obese mice
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“The mechanisms by which diet-induced obesity leads to cardiac injury development are not well understood [8–13], but it is known that glucose becomes an important preferential substrate for heart metabolism and adenosine triphosphate (ATP) generation under”
Background
Effects of Two Variants of Roux-en-Y Gastric Bypass on Metabolism Behaviour: Focus on Plasma Ghrelin Concentrations Over a 2-Year Follow-up
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“... now considered a global health epidemic, is increasing in prevalence in the United States and around the world [1] and is associated with a wide array of comorbidities, including high rates of cardiovascular disease, insulin resistance and type 2 diabetes, hypertension, hyperlipidaemia, sleep apnoea, pulmonary dys…”
Background
Transgenic Mice Overexpressing Serum Retinol-Binding Protein Develop Progressive Retinal Degeneration through a Retinoid-Independent Mechanism
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“De-creases in VAT contribute to improvements in certain components of metabolic syndrome, and thus potentially decrease the risk of cardiovascular disease (32).”
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Diabetes and atherothrombosis: The circadian rhythm and role of melatonin in vascular protection
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Metabolomic profiling as a useful tool for diagnosis and treatment of chronic disease: focus on obesity, diabetes and cardiovascular diseases
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“Being obese is also associated with diabetes mellitus [3,4], cardiovascular diseases [5,6], and cancers [4], all associated with metabolic disorders.”
Background
An assessment of anthropometric indices and its association with NCDs among the older adults of India: evidence from LASI Wave-1
Bramhankar, M., Pandey, M., Rana, G. S., Rai, B., Mishra, N. L., & Shukla, A. (2021) · BMC Public Health · doi:10.1186/s12889-021-11421-4 · Cited by 36
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“Background Obesity is the established main cause of hypertension and type 2 diabetes mellitus (T2DM) and can lead to the development of coronary vascular disease; furthermore, these 3 illnesses have attained the status of global epidemics recently [1-3].”
Background
Predictors of weight change in overweight patients with myocardial infarction
Fadl, Y. Y., Krumholz, H. M., Kosiborod, M., Masoudi, F. A., Peterson, P. N., Reid, K. J., Weintraub, W. S., Buchanan, D. M., & Spertus, J. A. (2007) · American Heart Journal · doi:10.1016/j.ahj.2007.06.006 · Cited by 32
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Effects of periodontitis on aortic insulin resistance in an obese rat model
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“2 The combination of obesity and its associated risk factors results in the development of cardiovascular diseases such as atherosclerosis”
Background
Oxidative Stress in Insulin-Resistant Conditions
Stump, C. S., Clark, S. E., & Sowers, J. R. (2005) · Treatments in Endocrinology · doi:10.2165/00024677-200504060-00003 · Cited by 31
Self-citation
Hypolipidemic Effects of Modified Psyllium Preparations
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“Overweight or obesity increase risk for hypertension [1,4-6], coronary heart disease [1,4,7,8], diabetes [1,4,9] and premature death [1,10].”
Background
Prenatal Programming and Epigenetics in the Genesis of the Cardiorenal Syndrome
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Self-citation
Metabolic Syndrome in Hypertensive Patients
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“In addition to NOX2 activation, chronic TNFα stimulation also causes insulin resistance (14, 58).”
Background
Biliopancreatic Diversion Reduces QT Interval and Dispersion in Severely Obese Patients
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“The most dangerous effects of SO, however, may be eliminated by weight loss (5).”
Background
Ldlr−/− Mice Display Decreased Susceptibility to Western-Type Diet-Induced Obesity Due to Increased Thermogenesis
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Metabolic syndrome and inflammation in adipose tissue occur at different times in animals submitted to a high-sugar/fat diet
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“An enzymic colorimetric kit was used to measure glucose (Bioclin; Belo Horizonte), TAG (Bioclin; Belo Horizonte) and NEFA (WAKO; HR Series NEFAHR((2))).”
Method
Cardiomyocyte-specific knockout of endothelin receptor a attenuates obesity cardiomyopathy
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“contractile dysfunction with respect to morbidity and mortality (14, 45).”
Background
Nebivolol in Obese and Non‐Obese Hypertensive Patients
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Self-citation
Novel thioamide derivatives as neutral CB1 receptor antagonists
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Antioxidant nutrient intake and supplements as potential moderators of cognitive decline and cardiovascular disease in obstructive sleep apnea
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Authors: Sowers, J. R.
Affiliations: Harry S. Truman Memorial Veterans' Hospital (US)
Corresponding author: Sowers, James R
ORCID: Sowers, James R
Venue: The American Journal of Medicine
Publisher: Elsevier BV
Published: 2003-12
Volume: 115
Issue: 8
Pages: 37-41
ISSN: 0002-9343 (ISSN-L)
DOI: 10.1016/j.amjmed.2003.08.012
OpenAlex: W2053454761
Cited by: 584
References: 53
Citations by year: 2026: 7 · 2025: 13 · 2024: 14 · 2023: 20 · 2022: 17 · 2021: 23 · 2020: 24 · 2019: 15 · 2018: 27 · 2017: 20 · 2016: 23 · 2015: 28 · 2014: 29 · 2013: 21 · 2012: 21
FWCI: 5.05
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: The American Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (R01-HL63904-01)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
Keywords: obesity, cardiovascular disease, abdominal obesity, visceral adipose tissue, insulin resistance, type 2 diabetes, hyperinsulinemia, dyslipidemia, adipokines, leptin, adiponectin, resistin, weight loss, thiazolidinediones, hypertension, cardiovascular risk factors
MeSH terms: Adipose Tissue, Blood Pressure, Cardiovascular Diseases, Humans, Insulin Resistance, Motor Activity, Obesity, Risk Factors, United States, Prevalence

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