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

2. OBESITY, why?OBESITY, why?

3. Calorie Difference: 257 calories
590 calories
Cheeseburger
20 Years Ago Today
333 calories

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

5. 610 Calories
6.9 ounces
Calorie Difference: 400 Calories
French Fries
20 Years Ago Today
210 Calories
2.4 ounces

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.

14. How does obesity cause
cardiovascular disease?

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

16. Obesity Hypertension ?

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

19. Obesity and Cardiovascular Risk
Eccentric Hypertrophy
Sodium Retention
Volume Expansion
Heart Rate ↑
Endothelial
Dysfunction
Diabetes Mellitus
Dyslipidemia
HypertensionHypertension
Cardiac Output ↑
Visceral ObesityVisceral Obesity
Atherosclerosis
Arterial Resistance ↑
Concentric Hypertrophy
Congestive Heart Failure (CHF),Congestive Heart Failure (CHF),
Coronary Artery Disease (CAD), Sudden DeathCoronary Artery Disease (CAD), Sudden Death

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