Cited by 218Cardiovascular Function and Risk FactorsCardiovascular Disease and AdiposityDiabetes, Cardiovascular Risks, and Lipoproteins

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Management of cardiovascular diseases in patients with obesity

Lavie, Carl J., Arena, Ross, Alpert, Martin A., Milani, Richard V., Ventura, Hector O.·2018·Nature Reviews Cardiology

DOI 10.1038/nrcardio.2017.108

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Abstract

The management of cardiovascular diseases (CVD) in patients with obesity presents numerous challenges. Obesity has a negative effect on almost all of the major CVD risk factors, and adversely influences cardiovascular structure and function. Patients who are overweight or obese have a higher incidence of almost all CVDs compared with patients who are of normal weight. However, those who are overweight or obese seem to have a better short-term and medium-term prognosis after major CVD events and interventional procedures or cardiac surgeries than leaner patients, a phenomenon termed the 'obesity paradox'. In considering the mechanisms underlying this paradox, we review evidence of the deleterious consequences of obesity in patients with coronary heart disease, and the limited data on the benefits of weight loss in patients with CVD. Additional studies are needed on the efficacy of purposeful weight loss on cardiovascular outcomes to determine the ideal body composition for patients with CVD.

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A nanoemulsion targeting adipose hypertrophy and hyperplasia shows anti-obesity efficiency in female mice
Lu, Y., Luo, Z., Zhou, H., Shi, Y., Zhu, Y., Guo, X., Huang, J., Zhang, J., Liu, X., Wang, S., et al. (2024) · Nature Communications · doi:10.1038/s41467-023-44416-3 · Cited by 28
Application of Receiver Operating Characteristics (ROC) on the Prediction of Obesity
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Triglyceride-Glucose Index’s Link to Cardiovascular Outcomes Post-Percutaneous Coronary Intervention in China: A Meta-Analysis
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Adipose Composition and Heart Failure Prognosis
Lavie, C. J., Milani, R. V., & Ventura, H. O. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.10.017 · Cited by 26
Self-citation
Effect of the Obesity Paradox on Mortality in Patients with Acute Coronary Syndrome: A Comprehensive Meta-analysis of the Literature
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Predicted visceral adiposity index in relation to risk of coronary heart disease and all-cause mortality: insights from NHANES
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Exercise in the Park or Gym? The Physiological and Mental Responses of Obese People Walking in Different Settings at Different Speeds: A Parallel Group Randomized Trial
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“People who are obese are at an increased risk for cardiovascular diseases (Lavie et al., 2018).”
Background
Changes in plasma free fatty acids in obese patients before and after bariatric surgery highlight alterations in lipid metabolism
Hierons, S. J., Abbas, K., Sobczak, A. I. S., Cerone, M., Smith, T., Ajjan, R., & Stewart, A. J. (2022) · Scientific Reports · doi:10.1038/s41598-022-19657-9 · Cited by 23
Precision in Promoting Physical Activity and Exercise With the Overarching Goal of Moving More
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Self-citation
Deubiquitinase USP25 Alleviates Obesity-Induced Cardiac Remodeling and Dysfunction by Downregulating TAK1 and Reducing TAK1-Mediated Inflammation
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Effect of a 12-Week Concurrent Training Intervention on Cardiometabolic Health in Obese Men: A Pilot Study
Amaro‐Gahete, F. J., Ponce‐González, J. G., Corral‐Pérez, J., Velázquez‐Díaz, D., Lavie, C. J., & Jiménez‐Pavón, D. (2021) · Frontiers in Physiology · doi:10.3389/fphys.2021.630831 · Cited by 21
Self-citation
Clinical Outcomes in Metabolically Healthy and Unhealthy Obese and Overweight Patients With Atrial Fibrillation: Findings From the GLORIA-AF Registry
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Effect of Bariatric Surgery on Cardiovascular Function and Heart Failure Outcomes
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Background
Sarcopenic obesity: patterns and paradoxes
Drapkina, O. M., Budnevsky, A. V., Ovsyannikov, Е. S., Васильевна, К. А., & Дробышева, Е. С. (2021) · Russian Journal of Preventive Medicine · doi:10.17116/profmed20212401173 · Cited by 20
Machine learning-based prognostication of mortality in stroke patients
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Effect of Body Mass Index on Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke
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“Email: yzjin@cmu.edu.cn K E Y W O R D S body mass index, meta- analysis, obesity, percutaneous coronary intervention, ST- segment elevation myocardial infarction fibrillation (Lavie et al., 2016, 2017; Sandhu et al., 2018).”
Method
Angiogenesis–Browning Interplay Mediated by Asprosin-Knockout Contributes to Weight Loss in Mice with Obesity
Yin, T., Chen, S., Zeng, G., Yuan, W., Lu, Y., Zhang, Y., Huang, Q., Xiong, X., Xu, B., & Huang, Q. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms232416166 · Cited by 17
Rapid detection of drugs in blood using “molecular hook” surface-enhanced Raman spectroscopy and artificial intelligence technology for clinical applications
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Heart failure and obesity
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“1116 их распространенность и тяжесть [3].”
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“tive roles in an established CVD (Figure 2).(122,123)”
Background
Association of obesity indices with in-hospital and 1-year mortality following acute coronary syndrome
Balayah, Z., Alsheikh-Ali, A. A. A., Rashed, W. A., Almahmeed, W. A., Mulla, A. A., Al‐Rawahi, N., Mora, S., Dugani, S. B., & Zubaid, M. (2020) · International Journal of Obesity · doi:10.1038/s41366-020-00679-0 · Cited by 16
“9%) [7], or with unverifiable values for weight, height, or waist circumference (n= 31; 0.”
Background
Trends of overweight and obesity prevalence in school-aged children among Henan Province from 2000 to 2019
Zhang, Y., Lou, H., Ye, H., Wang, R., Wen, X., Wu, C., Hao, C., Li, R., Gao, G., Lou, X., et al. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1046026 · Cited by 16
Regular aerobic exercise activates PDGF-BB/PDGFR-β signaling and modulates the inflammatory-anti-inflammatory balance in diet-induced obese mice
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Cardiovascular Outcomes according to Comorbidities and Low-Density Lipoprotein Cholesterol in Korean People with Type 2 Diabetes Mellitus
Moon, M., Noh, J.-M., Rhee, E., Park, S. H., Kim, H. C., Kim, B.-J., Kim, H., Choi, S., Na, J., Hyun, Y., et al. (2023) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2021.0344 · Cited by 11
“In addition, obesity can be related to the increased muscle mass and strength represented as physical activity or cardiorespiratory fitness [26].”
Background
Deletion of Cardiomyocyte Glycogen Synthase Kinase-3 Beta (GSK-3β) Improves Systemic Glucose Tolerance with Maintained Heart Function in Established Obesity
Gupte, M., Umbarkar, P., Singh, A. P., Zhang, Q., Tousif, S., & Lal, H. (2020) · Cells · doi:10.3390/cells9051120 · Cited by 15
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Effect of Cardiorespiratory Fitness on Risk of Sudden Cardiac Death in Overweight/Obese Men Aged 42 to 60 Years
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The waist-to-body mass index ratio as an anthropometric predictor for cardiovascular outcome in subjects with established atherosclerotic cardiovascular disease
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“A readiness for discharge from an ICU assessment requires the evaluation of the patient’s physiological stability, cognitive and psychomotor ability to carry out self-management regimens, social support availability and permanent access to healthcare systems [84].”
Background
Deletion of miRNA-22 Induces Cardiac Hypertrophy in Females but Attenuates Obesogenic Diet-Mediated Metabolic Disorders.
Silva, T. D. O., Lino, C. A., Buzatto, V. C., Asprino, P. F., Lu, Y. W., Lima, V. M., Fonseca, R. I., Jensen, L., Murata, G. M., Filho, S. V., et al. (2020) · Cellular Physiology and Biochemistry · doi:10.33594/000000309 · Cited by 14
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“As we previously described, overweight or class I obesity patients seem to have better survival outcomes than normal-weight individuals in patients with AF, a phenomenon that is known as the “obesity paradox” [16, 48].”
Background
Impact of Overweight/Obesity on Clinical Outcomes of Patient with Vasospastic Angina: From the Vasospastic Angina in Korea Registry
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Gestational diabetes mellitus and cardio-metabolic risk factors in women and children at 3 years postpartum
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“Similarly, children who were born to mothers with GDM were compared for CVD risk factors with children who were born to mothers without GDM. Univariate analysis was used to compare anthropometric and baseline variables between GDM and normoglycemic pregnancies, with data presented as mean (SD) or n (%).”
MethodInfluential
Comparing and contrasting risk factors for heart failure in patients with and without history of myocardial infarction: data from HOMAGE and the UK Biobank
Rastogi, T., Ho, F. K. W., Rossignol, P., Merkling, T., Butler, J., Clark, A. L., Collier, T. J., Delles, C., Jukema, J. W., Heymans, S. R. B., et al. (2022) · European Journal of Heart Failure · doi:10.1002/ejhf.2495 · Cited by 12
“32,33 Diabetes, hypertension and obesity are associated with impaired myocardial energy consumption, cardiac hypertrophy and oxidative damage.”
Background
The association between different body mass index levels and midterm surgical revascularization outcomes
Masoudkabir, F., Yavari, N., Jameie, M., Pashang, M., Sadeghian, S., Salarifar, M., Jalali, A., Tafti, S. H. A., Abbasi, K., Omran, A. S., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0274129 · Cited by 12

Authors: Lavie, C. J., Arena, R., Alpert, M. A., Milani, R. V., & Ventura, H. O.
Affiliations: Ochsner Health System (US)
University of Illinois Chicago (US)
University of Missouri (US)
Corresponding author: Lavie, Carl J.
ORCID: Lavie, Carl J.
Arena, Ross
Alpert, Martin A.
Milani, Richard V.
Venue: Nature Reviews Cardiology
Publisher: Springer Science and Business Media LLC
Published: 2017-07-27
Volume: 15
Issue: 1
Pages: 45-56
ISSN: 1759-5002 (ISSN-L)
1759-5010
DOI: 10.1038/nrcardio.2017.108
OpenAlex: W2741252257
Cited by: 218
References: 135
Citations by year: 2026: 9 · 2025: 18 · 2024: 23 · 2023: 34 · 2022: 34 · 2021: 27 · 2020: 26 · 2019: 16 · 2018: 30 · 2017: 1
FWCI: 2.81
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Nature Reviews Cardiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: obesity, cardiovascular disease, obesity paradox, weight loss, coronary artery disease, cardiovascular risk factors, body composition, cardiovascular outcomes
MeSH terms: Cardiovascular Diseases, Humans, Obesity, Morbid, Weight Loss

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