The Obesity Paradox, Weight Loss, and Coronary Disease

Lavie, Carl J.; Milani, Richard V.; Artham, Surya M.; Patel, Dharmendrakumar A.; Ventura, Héctor O.

doi:10.1016/j.amjmed.2009.06.006

Cited by 231 publications

(155 citation statements)

References 60 publications

Supporting

Mentioning

130

Contrasting

Unclassified

Order By: Relevance

“…La obesidad se asocia con otros factores de riesgo -presión arterial, lípidos sanguíneos y tolerancia a la glucosa 39 -, y la pérdida de peso ha mostrado impactar positivamente en su control y mejorar la calidad de vida 40 . Por otra parte, el ejercicio físico ayuda a mantener la baja de peso, tiene un efecto beneficioso en la circulación coronaria, la función endotelial y en los otros factores de riesgo 12,24,41,42 .…”

Section: Discussionunclassified

Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES

et al. 2013

View full text Add to dashboard Cite

show abstract

Section: Discussionunclassified

Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES

et al. 2013

View full text Add to dashboard Cite

show abstract

“…[9][10][11][12][13]28 Part of the explanation for the unexpected association between BMI and outcomes in CHD and other CV diseases could be due to the poor diagnostic performance of BMI to define body fatness and lean body mass, factors that could be associated with opposing outcomes in CV diseases. 1,[8][9][10][11][12][13][14]29 In fact, the group from Mayo Clinic has previously demonstrated that BMI performs suboptimally in predicting obesity as defined by BF (>25% in men and >35% in women) in a CHD population. 9 Some clinical populations have low BMI and high BF and have higher CHD prevalence than do their low BF counterparts.…”

Section: Discussionmentioning

confidence: 99%

“…14 Patients were divided into low (<25) and high (≥25) BMI. Elevated BF has been defined as greater than 25% in men and greater than 35% in women, 15,16 so patients were also divided into low (≤25% men and ≤35% women) and high BF (>25% men and >35% women).…”

Section: Methodsmentioning

confidence: 99%

“…2,[9][10][11][12][13] We have recently demonstrated this obesity paradox in a cohort of CHD patients using both BMI and BF determinations. 14 To our knowledge, no prior studies have determined the independent effects of both BMI and BF on mortality in a cohort of CHD patients. Therefore, in the current evaluation, we determined the combined and independent impact of both BMI and BF on mortality in a cohort with stable CHD.…”

Section: Body Composition and Heart Disease Mortalitymentioning

confidence: 99%

“…Body fat was assessed by the sum of the skinfold method using the average of 3 skinfolds-chest, thigh, and abdomen in men; thigh, triceps, and suprailiac in women, as previously described. 14,17 All measurements were made in the early morning before exercise testing. Symptom-limited cardiopulmonary exercise testing was performed (as previously described in detail) to assess peak oxygen consumption (peak V · o 2 ).…”

Section: Baseline Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Body Composition and Coronary Heart Disease Mortality—An Obesity or a Lean Paradox?

Lavie¹,

Schutter²,

Patel³

et al. 2011

Mayo Clinic Proceedings

Self Cite

138

View full text Add to dashboard Cite

Body Composition and Heart disease mortalityFor personal use. Mass reproduce only with permission from Mayo Clinic Proceedings a .D espite the well-known adverse affects of obesity on almost all aspects of coronary heart disease (CHD) and CHD risk factors, including hypertension (HTN), plasma lipids, inflammation, glucose abnormalities, insulin resistance, metabolic syndrome and type 2 diabetes mellitus (T2DM), as well as left ventricular hypertrophy (LVH), many studies of cohorts with established cardiovascular (CV) disease, including heart failure (HF), HTN, as well as CHD, have demonstrated an inverse relationship between obesity, generally determined by body mass index (BMI [calculated as the weight in kilograms divided by the height in meters squared]), on subsequent mortality, referred to as the obesity paradox. 1,2 The obesity paradox has also been demonstrated in non-CV studies that included patients with advanced renal disease and the elderly. 3,4 Many large studies of cohorts with CHD have demonstrated this obesity paradox, [5][6][7] which has also been demonstrated in a large meta-analysis by Romero-Corral et al 8 from Mayo Clinic, who analyzed 40 cohort studies totaling more than 250,000 patients with CHD grouped according to BMI.Although BMI is the most frequently used method to assess overweightness/obesity, especially in large epidemiologic studies, this method has been criticized because BMI does not always reflect true body fatness. 1,2,9-14 Some investigators have theorized that at least part of the inconsistent relationship between obesity and major CV disease events, including mortality, may be due to the inaccurate diagnosis of obesity by the BMI assessment and that defining obesity by other methods, including waist circumference, waist/hip ratio, as well as percent body fat (BF) may be more accurate. 2,[9][10][11][12][13] We have recently demonstrated this obesity paradox in a cohort of CHD patients using both BMI and BF determinations. 14 To our knowledge, no prior studies have determined the independent effects of both BMI and BF on mortality in a cohort of CHD patients. Therefore, in the current evaluation, we determined the combined and independent impact of both BMI and BF on mortality in a cohort with stable CHD. PATIENTS AND METHODSWe retrospectively reviewed the case records of 581 consecutive patients with stable CHD who were referred for potential entry into formal cardiac rehabilitation programs between January 1, 2000, and July 31, 2005, and who had baseline anthropometric, lipid, and clinical data, as we have previously described. 14 Patients were divided into low (<25) and high (≥25) BMI. Elevated BF has been defined as greater than 25% in men and greater than 35% in women, 15,16 so patients were also divided into low (≤25% men and ≤35% women) and high BF (>25% men and >35% women Objective: To determine the combined effects of body mass index (BMI) and body fat (BF) on prognosis in coronary heart disease (CHD) to better understand the obesity paradox. Patients and MethOds:We s...

show abstract

Impact of body mass index on long‐term clinical outcomes after second‐generation drug eluting stent implantation: Insights from the international global RESOLUTE program

Diletti

García‐García

Bourantas

et al. 2015

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

The Obesity Paradox, Weight Loss, and Coronary Disease

Cited by 231 publications

References 60 publications

Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES

Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES

Body Composition and Coronary Heart Disease Mortality—An Obesity or a Lean Paradox?

Impact of body mass index on long‐term clinical outcomes after second‐generation drug eluting stent implantation: Insights from the international global RESOLUTE program

Contact Info

Product

Resources

About