Abdominal Obesity vs. CVD: Beyond Body Weight

Defining CMR - Epidemiology


Though most experts agree that soaring obesity rates have played a key role in the rise of chronic complications such as type 2 diabetes, hypertension, and cardiovascular disease (CVD), obesity continues to confound clinicians from both an assessment and management standpoint. One of the main reasons why is obesity’s remarkable heterogeneity. For example, some very obese individuals have normal blood pressure, a normal plasma lipid profile, and normal blood glucose despite having a large amount of fat. However, other individuals with an apparently “healthy” body weight sometimes have a disturbed metabolic risk factor profile. In light of this, it is important to stress the importance of abdominal obesity as the form of overweight/obesity most likely to entail the highest risk of CVD.

Obesity and CVD


Key Points

  • Obesity is a key determinant of CVD. When compared to normal weight individuals, obese patients have several metabolic complications that increase their CVD risk.
  • Although much epidemiological evidence has shown that obesity is a major CVD risk factor, not all obese individuals are at increased risk of CVD.
  • Because of the differences observed among obese individuals, special attention must be paid to body fat distribution and to abdominal adipose tissue accumulation in particular, which usually worsens the metabolic profile of overweight/obese patients.


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Abdominal Obesity and CVD


Key Points

  • Metabolic studies have shown that in both men and women the amount of visceral adipose tissue is strongly linked to metabolic abnormalities that increase the risk of type 2 diabetes and CVD.
  • Overall obesity increases CVD risk. A wealth of data also indicates that obese individuals with high levels of abdominal fat—visceral fat in particular—form an obese subgroup with the worst metabolic profile.
  • Because not every obese patient is at increased risk of CVD, the challenge for clinicians is to identify the subgroup of patients at highest risk of CVD. This requires clinicians to do more than measure body weight and calculate BMI.
  • In order to properly evaluate CVD risk among overweight/obese patients, emphasis should be placed on estimating visceral adipose tissue using simple tools such as waist circumference.


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