The obesity and its meaning in cardiovascular diseases Part 2. Obesity paradox
DOI:
https://doi.org/10.15584/przmed.2015.2.10Keywords:
obesity paradox, overweight, cardiac failure, hypertensionAbstract
There are many papers on the different influence of obesity and overweight on appearance and prognosis of circulatory system diseases. In previous part we tried to present the obesity and its pathogenic influence on the formation of circulatory system diseases i.e. the obesity as a risk factor. In the second part we present the data on better prognosis in patients with advanced circulatory diseases. This is called the obesity paradox. It refers to HT, CAD, MF, HF. It seems to be protective and brings advantages in the course of disease. Fat tissue can be a source of energy in advanced diseases which cause a stress reaction. This creates the energy demands, the fulfil of which is impossible by the lack of reserves. It is confirmed by clinical observations. The highest mortality rate is observed in patients with underweight and extreme obesity (BMI > 35), and the lowest in group with normal weight and mild obesity. So, the obesity paradox means better prognosis for patients with obesity and overweight with CV diseases. The best explanation of this phenomenon is an HF example, where in the situation of negative energetic balance (underweight) during the aggravation of illness („inflammation“) the exhaust of resources takes place. It means superiority of catabolism processes and leads progressively to cachexia and death. On the other hand, where there is an excess of resources (overweight, obesity) it can be used, consumed and the exacerbation of HF is milder. The overweight paradox among the healthy ones means better prognosis for longer life.
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