Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association

作者：Tiffany M. Powell‐Wiley, Paul Poirier, Lora E. Burke, Jean‐Pierre Després, Penny Gordon‐Larsen, Carl J. Lavie, Scott Alexander Lear, Chiadi E. Ndumele, Ian J. Neeland, Prashanthan Sanders, Marie‐Pierre St‐Onge · 发表于：Circulation · 年份：2021 · DOI：10.1161/cir.0000000000000973 · 被引用次数：3718 · 研究领域：Cardiovascular Disease and Adiposity、Cardiovascular Function and Risk Factors、Cardiac Imaging and Diagnostics

The global obesity epidemic is well established, with increases in obesity prevalence for most countries since the 1980s. Obesity contributes directly to incident cardiovascular risk factors, including dyslipidemia, type 2 diabetes, hypertension, and sleep disorders. Obesity also leads to the development of cardiovascular disease and cardiovascular disease mortality independently of other cardiovascular risk factors. More recent data highlight abdominal obesity, as determined by waist circumference, as a cardiovascular disease risk marker that is independent of body mass index. There have also been significant advances in imaging modalities for characterizing body composition, including visceral adiposity. Studies that quantify fat depots, including ectopic fat, support excess visceral adiposity as an independent indicator of poor cardiovascular outcomes. Lifestyle modification and subsequent weight loss improve both metabolic syndrome and associated systemic inflammation and endothelial dysfunction. However, clinical trials of medical weight loss have not demonstrated a reduction in coronary artery disease rates. In contrast, prospective studies comparing patients undergoing bariatric surgery with nonsurgical patients with obesity have shown reduced coronary artery disease risk with surgery. In this statement, we summarize the impact of obesity on the diagnosis, clinical management, and outcomes of atherosclerotic cardiovascular disease, heart failure, and arrhythmias, espec...