Abdominal obesity, an independent cardiovascular risk factor in Indian subcontinent: A clinico epidemiological evidence summary

Abstract

Evidence is emerging that obesity-associated cardiovascular disorders (CVD) show variations across regions and ethnicities. However, it is unclear if there are distinctive patterns of abdominal obesity contributing to an increased CVD risk in South Asians. Also, potential underlying mechanistic pathways of such unique patterns are not comprehensively reported in South Asians. This review sets out to examine both. A comprehensive database search strategy was undertaken, namely, PubMed, Embase and Cochrane Library, applying specific search terms for potentially relevant published literature in English language. Grey literature, including scientific meeting abstracts, expert consultations, text books and government/non-government publications were also retrieved. South Asians have 3-5% higher body fat than whites, at any given body mass index. Additional distinctive features, such as South Asian phenotype, low adipokine production, lower lean body mass, ethno-specific socio-cultural and economic factors, were considered as potential contributors to an early age-onset of obesity-linked CVD risk in South Asians. Proven cost-effective anti-obesity strategies, including the development of ethno-specific clinical risk assessment tools, should be adopted early in the life-course to prevent premature CVD deaths and morbidity in South Asians.

Association of waist and hip circumferences with the presence of hypertension and pre-hypertension in young South African adults

“…Obesity is generally assessed using BMI which gives information on the distribution of weight with respect to height but fails to give insight into adipose tissue distribution phenotype. Evidence gathered from several studies shows that central obesity (accumulation of fat in the abdominal area) is a greater risk factor for CVDs compared to other types of obesity [5][6][7] hence the need to know the distribution of fat in patients to facilitate assessment of patient's risk profile for CVDs. This has led investigators to use various anthropometric measurements such as WC, HC, WHR, waist-to-height ratio (WHtR), visceral fat (VF) and total body fat (TBF) as well as skin fold thickness [8][9][10] to establish which of these variables would show better association with CVDs or help predict risk.…”

A study on prevalence of pre-hypertension in relation to various obesity indicators in tenth standard healthy school children aged 14 to 16 years

“…Childhood high blood pressure is risk for adult hypertension. 3,4 Obesity is the strongest modifiable risk factor for childhood hypertension. 5 Unlike recommendations for the diagnosis of hypertension in children that require elevation of BP on 3 separate occasions, repeated measures are not necessary to classify an adolescent as pre-hypertensive.…”

Young Ischemic Stroke in South Asia: A review

“…35,49 Unique anthropometry and Thinfat phenotype among South Asians, where there is low Basal metabolic index and higher amount of central obesity, are the cardiometabolic risk factors. 50 Abdominal obesity in young, which is more associated with atherosclerosis, hypertension and diabetes, is found to be more common in South Asians than westerners. 48,51 Obesity was found to be neglected in most studies of South Asian young stroke.…”