Artham Surya M, Lavie Carl J, Milani Richard V, Ventura Hector O
Ochsner Medical Center, New Orleans, LA 70121-2483, USA.
Postgrad Med. 2008 Jul;120(2):34-41. doi: 10.3810/pgm.2008.07.1788.
Obesity has reached global epidemic proportions and is associated with numerous comorbidities such as hypertension (HTN), type 2 diabetes mellitus, dyslipidemia, certain cancers, and chronic kidney disease (CKD). Obesity, via its direct maladaptive effects on cardiac structure and through its impact on conventional risk factors, is strongly associated with cardiovascular (CV) diseases such as heart failure (HF) and coronary heart disease (CHD). Despite these adverse associations, numerous studies indicate an "obesity paradox" in that being overweight or obese is associated with a favorable prognosis in many patients with established CV disease, particularly in patients with HTN, HF, and CHD. This review summarizes the adverse effects of obesity on CV disease risk factors and its role in the genesis of HTN, HF, CHD, and the obesity paradox. It concludes with a discussion on the potential benefits of weight loss in these patient populations.
肥胖已达到全球流行程度，并与多种合并症相关，如高血压（HTN）、2型糖尿病、血脂异常、某些癌症和慢性肾脏病（CKD）。肥胖通过对心脏结构的直接不良影响以及对传统危险因素的作用，与心血管（CV）疾病如心力衰竭（HF）和冠心病（CHD）密切相关。尽管存在这些不良关联，但大量研究表明存在“肥胖悖论”，即超重或肥胖在许多已确诊CV疾病的患者中，尤其是高血压、心力衰竭和冠心病患者中，与较好的预后相关。本综述总结了肥胖对CV疾病危险因素的不良影响及其在高血压、心力衰竭、冠心病发生中的作用，以及肥胖悖论。最后讨论了这些患者群体中体重减轻的潜在益处。
