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Heart and cardiovascular system

Obesity, a good metabolism does not exclude cardiovascular risk

January 1, 2018


Obese people who are “metabolically healthy” have a greater risk of stroke, coronary heart disease and major heart failure than normal-weight people. To further confirm this, a research was carried out by the University of Birmingham (United Kingdom) on data relating to 3.5 million adults and published on the Journal of the American College of Cardiology: ‘We cannot talk about “healthy obesity” or “fat and fit” and indicating individuals with extra body weight but still healthy. Even though there is a healthy metabolic profile, cardiovascular risk is still considerable’, adds Dr. Maddalena Lettino, Head of the Cardiology and Heart Failure Unit at Humanitas.


The researchers divided the examined population into different groups based on the Body Mass Index (BMI) and the presence/absence of three metabolism abnormalities: diabetes, hyperlipidemia and hypertension. Each alteration was associated to a different score, from zero to three. Those who scored zero points were considered metabolically healthy obese.


This group was compared with normal-weight subjects to evaluate the risk of developing coronary artery disease, transient ischemic attack or stroke, heart failure and peripheral vascular disease. Compared to those with a normal BMI, the metabolically healthy obese individuals had a 50% greater risk of developing coronary heart disease, 7% of strokes or “mini-strokes”, and doubled risk of developing heart failure.


Excess weight is a risk element

Furthermore, the risk of adverse events increased with increasing risk factors. With all three, the risk of coronary heart disease was 2.6 times than the one of normal-weight subjects and the risk of stroke was almost 60%: ‘This is scientific evidence that consolidates the importance of body weight control and the need to lose extra kilos to preserve the health of the cardio-cerebrovascular system’, warns Dr. Lettino.



‘Obesity itself is a risk factor and if it is associated with hypertension, diabetes or hypercholesterolemia, the risk for those conditions also increases. The coexistence of obesity and changes in metabolism is very likely for obese adults after forty, but even obese young people must still pay attention to their health. All the awareness campaigns related to these aspects are focused exactly on the young population, in order to prevent the risks associated with obesity’, concludes the specialist.

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