Kachur Sergey, Lavie Carl J, de Schutter Alban, Milani Richard V, Ventura Hector O
Department of Graduate Medical Education, Ocala Regional Medical Center, Ocala, FL, USA -
Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA, USA.
Minerva Med. 2017 Jun;108(3):212-228. doi: 10.23736/S0026-4806.17.05022-4. Epub 2017 Feb 1.
Obesity is increasingly more common in postindustrial societies, and the burden of childhood obesity is increasing. The major effects of obesity on cardiovascular (CV) health are mediated through the risk of metabolic syndrome (insulin-resistance, dyslipidemia, and hypertension), such that an absence of these risk factors in obese individuals may not be associated with increased mortality risk. In individuals already diagnosed with chronic CV disease (CVD), the overweight and class I obese have significant associations with improved survival. However, this effect is attenuated by increases in cardiorespiratory fitness. The negative effects of obesity on CV health manifest as accelerated progression of atherosclerosis, higher rates of ventricular remodeling and a higher risk of associated diseases, including stroke, myocardial infarction, and heart failure. The most effective therapies at reversing CVD risk factors associated with obesity have been dietary changes with exercise, especially through structured exercise programs, such as cardiac rehabilitation.
肥胖在工业化后的社会中越来越普遍,儿童肥胖的负担也在增加。肥胖对心血管(CV)健康的主要影响是通过代谢综合征(胰岛素抵抗、血脂异常和高血压)的风险介导的,因此肥胖个体中不存在这些风险因素可能与死亡风险增加无关。在已经被诊断患有慢性心血管疾病(CVD)的个体中,超重和I类肥胖与生存率提高有显著关联。然而,这种效应会因心肺适能的增加而减弱。肥胖对心血管健康的负面影响表现为动脉粥样硬化加速进展、心室重塑率更高以及包括中风、心肌梗死和心力衰竭在内的相关疾病风险更高。逆转与肥胖相关的心血管疾病风险因素的最有效疗法是饮食改变与运动,特别是通过结构化运动计划,如心脏康复。