PRESENTED BY: AYESHA KABEER
FROM: UNIVERSITY OF GUJRAT SIALKOT SUBCAMPUS
Obesity and Cardiovascular Diseases
1. Causes of Overweight and Obesity
2. Accessing Obesity
-Body Mass Index
3. Cardiovascular Diseases caused by Obesity
4. Calorie Difference: 525 calories
1,025 calories
2 cups of pasta with sauce and 3
large meatballs
20 Years Ago Today
500 calories
1 cup spaghetti with sauce and
3 small meatballs
Spaghetti and Meatballs
6. Coffee
20 Years Ago
Coffee
(with whole milk and sugar)
Today
Mocha Coffee
(with steamed whole milk and
mocha syrup)
45 calories
8 ounces
350 calories
16 ounces
Calorie Difference: 305 calories
7. Causes of Overweight & Obesity
Science shows that genetics does play a role in obesity
– However in most cases, both genes and behavior are necessary for
a person to be overweight
Body weight is the result of a combination of influences:
– genetic, metabolic, behavioral, environmental, cultural influences
8. Assessing Obesity
Measurement of body fat by:
– hydro densitometry
– x-ray absorptiometry
– bioelectrical impedance analysis (BIA)
– skinfold thickness measurement
Waist circumference.
– Above 40 inches for men and 35 inches for women are
indicative of health risk.
9. Assessing Obesity: BMI
Body mass index (BMI)
– calculated as weight in kilos divided by height in meters
squared.
– evaluates weight relative to height
– used most by researchers and health organizations in
measuring and defining overweight and obesity.
10. Weight Classification by BMI
Underweight < 18.5 Underweight
Normal 18.5 – 24.9 Normal range
Overweight 25.0 – 29.9 Preobese
Obesity class 1 30.0 – 34.9 Obese class 1
Obesity class 2 35.0 – 39.9 Obese class 2
Obesity class 3 ≥ 40.0 Obese class 3
NHLBI = National Heart, Lung, and Blood Institute; WHO = World Health Organization.
NHLBI
Terminology
BMI,
kg/m2
, Range
WHO
Classification
11. Classic Risk Factors in CAD
Diabetes
Nicotine
Obesity and lack
of exercise
Dyslipidemia
Hypertension CAD
12. Obesity and Overweight Increase the Risk of:
Hypertension
Stroke
Diabetes mellitus, Type 2
Metabolic syndrome
CV mortality
Cancer – endometrium, breast, prostate, and colon.
Gallbladder disease
Osteoarthritis
Respiratory diseases and sleep-apnea
13. Obesity and Cardiovascular Disease
0
1
2
3
4
RelativeRisk
Relative Risk of Nonfatal MI and Fatal CHD
(Combined) Based on BMI (Women)
< 21 21 – 22.9 23 – 24.9 25 – 28.9 ≥ 29
BMI (kg/m2
)
MI = myocardial infarction.
15. Obesity and Insulin Resistance
HyperinsulinemiaHyperinsulinemia
++
HyperglycemiaHyperglycemia
Activation of the
sympathetic nervous
system
Increase of arterial tone
Na+ reabsorption
Hypertension
Overstimulation of
pancreatic β-cell
function
Reduction of insulin
secretion
Type 2 Diabetes
17. HYPERTENSION & OBESITY
Epidemiological studies have shown
a correlation between body weight
and blood pressure—
70% of hypertension in men and
60% in women are associated with
excess adiposity
18. Obesity and Hypertension
Insulin ResistanceInsulin Resistance
++
HyperinsulinemiaHyperinsulinemia
Activation of the sympathetic nervous system
↑ Vasoconstriction ↑ Cardiac output
↑ Na+
reabsorption
Blood Pressure
20. Considerations in Selecting Pharmacological
Agents For Treating Obesity-related Hypertension
Agent Potential Benefits Potential Drawbacks
Diuretics (low
dose)
↓ intravascular volume and
cardiac output
May antagonize enhanced SNS activity
of obesity-related hypertension
Improvement in metabolic profile
↑ SNS and RAS activity
Possible dose-related worsening of insulin
resistance and dyslipidemia
↑ risk of both weight gain and diabetes
Possible interference with carbohydrate and lipid
metabolism
Beta blockers
Alpha blockers
21. Health Benefits of Modest Weight Loss*
Possible risk of death
CHD risk
MI rate
stroke rate
Can significantly reduce sleep apnea
osteoarthritis symptoms
22. Management of Obesity: Treatment Options
Modality Recommendation
Reduced-calorie diet Reduce energy intake by 500 to 1,000 kcal/day to achieve a weight
loss of 1 to 2 lbs/week over a 6-month period
Start with 30 to 45 minutes moderate activity 3 to 5 days/week, and
work up to at least 30 minutes moderate-intensity physical activity
on most or all days/week
Use multiple behavioral strategies (eg, self-monitoring of eating
habits and physical activity)
Consider for patients with class 3 obesity, or class 2 obesity with
comorbid conditions, for whom other treatments have failed
Increased activity
Behavior modification
Surgery
Editor's Notes
There are variuos ways of assessing obesity and this include:
Weight levels have been classified by the WHO and NHLBI based on the BMI’s.
Another slide in women 30-55 years of age showing the the relatioship between BMI and CVD. Notice that at a BMI of 25-28 which is only overweigh and not even obese the the combines rates of non fatal MI and fatal CHD is twice that of non-overweight patients and about 4x as muchc in the obese group.
