This indicates that even in the absence of metabolic abnormalities , overweight and obesity are not innocuous , perhaps because the traditional cardiovascular risk factors are either not present early or remain undetected using routine clinical assessment .
This raises the concept that early or sub clinical organ damage assessment s may be better at identifying subjects who are more likely to progress to develop cardiovascular disease .
Obesity and Consequences The prevalence of overweight and obesity has reached epidemic proportion , with the recent figures from the World Health Organization indicating that in 2016 39 % of adults aged ≥18 years ( 39 % of men and 40 % of women ) were overweight and 13 % ( 11 % of men and 15 % of women ) obese .
The World Health Organization states that raised body mass index ( BMI ) is a major risk factor for noncommunicable diseases such as cardiovascular diseases ( mainly heart disease and stroke ) , which were the leading causes of death in 2012 , diabetes mellitus , musculoskeletal disorders , and some cancers .
The Framingham Heart Study data have indicated that overweight and obesity are associated with significantly decreased life expectancy .
Nevertheless , and against these strong evidence s , the relationship between BMI and mortality has been challenged by several studies , indicating a survival advantages for those who are overweight and class I obese .
However , the determinants of these observations are poorly understood and continue to be debated because BMI may not be the ideal index of adiposity and fat distribution and fitness and disease prevention may obscure the link between BMI and mortality .
Overweight or obesity is not always accompanied by traditional risk factors .
In fact , a systematic review and meta analysis revealed that about 35 % of obese individuals are metabolically healthy .
There is evidence that an important factor driving at least some of the obesity-associated end-organ damage is overactivity of the sympathetic nervous system ( SNS ) , an observation that suggests that targeting SNS in obesity may help reduce the cardiovascular risk associated with obesity .
In this review , we highlight the current knowledge of the potential role of SNS function in obesity-induced organ damage and examine whether interventions aim ed at reducing cardiovascular risk in obesity may be mediated via alterations in SNS activity .
Usefulness of brachial artery flow-mediated dilation to predict long-term cardiovascular events in subjects without heart disease.
Endothelial dysfunction is considered an important prognostic factor in atherosclerosis . To determine the long-term association of brachial artery flow-mediated dilation ( FMD ) and adverse cardiovascular ( CV ) events in healthy subjects , we prospect ively assessed brachial FMD in 618 consecutive healthy subjects with no apparent heart disease , 387 men ( 63 % ) , and mean age 54 ± 11 years . After overnight fasting and discontinuation of all medications for ≥12 hours , FMD was assessed using high-resolution linear array ultrasound . Subjects were divided into 2 groups : FMD ≤11.3 % ( n = 309 ) and > 11.3 % ( n = 309 ) , where 11.3 % is the median FMD , and were comparable regarding CV risk factors , lipoproteins , fasting glucose , C-reactive protein , concomitant medications , and Framingham 10-year risk score . In a mean clinical follow-up of 4.6 ± 1.8 years , the composite CV events ( all-cause mortality , nonfatal myocardial infa rct ion , hospitalization for heart failure or angina pectoris , stroke , coronary artery bypass grafting , and percutaneous coronary interventions ) were significantly more common in subjects with FMD ≤11.3 % rather than > 11.3 % ( 15.2 % vs 1.2 % , p = 0.0001 , respectively ) . Univariate analysis demonstrated that the median FMD significantly predicted CV events ( odds ratio 2.78 , 95 % CI 1.35 to 5.71 , p < 0.001 ) . Multivariate analysis , controlling for traditional CV risk factors , demonstrated that median FMD was the best independent predictor of long-term CV adverse events ( odds ratio 2.93 , 95 % CI 1.28 to 6.68 , p < 0.001 ) . In conclusion , brachial artery median FMD independently predicts long-term adverse CV events in healthy subjects with no apparent heart disease in addition to those derived from traditional risk factor assessment
This indicates that even in the absence of metabolic abnormalities , overweight and obesity are not innocuous , perhaps because the traditional cardiovascular risk factors are either not present early or remain undetected using routine clinical assessment .
This raises the concept that early or sub clinical organ damage assessment s may be better at identifying subjects who are more likely to progress to develop cardiovascular disease .
Obesity and Consequences The prevalence of overweight and obesity has reached epidemic proportion , with the recent figures from the World Health Organization indicating that in 2016 39 % of adults aged ≥18 years ( 39 % of men and 40 % of women ) were overweight and 13 % ( 11 % of men and 15 % of women ) obese .
The World Health Organization states that raised body mass index ( BMI ) is a major risk factor for noncommunicable diseases such as cardiovascular diseases ( mainly heart disease and stroke ) , which were the leading causes of death in 2012 , diabetes mellitus , musculoskeletal disorders , and some cancers .
The Framingham Heart Study data have indicated that overweight and obesity are associated with significantly decreased life expectancy .
Nevertheless , and against these strong evidence s , the relationship between BMI and mortality has been challenged by several studies , indicating a survival advantages for those who are overweight and class I obese .
However , the determinants of these observations are poorly understood and continue to be debated because BMI may not be the ideal index of adiposity and fat distribution and fitness and disease prevention may obscure the link between BMI and mortality .
Overweight or obesity is not always accompanied by traditional risk factors .
In fact , a systematic review and meta analysis revealed that about 35 % of obese individuals are metabolically healthy .
There is evidence that an important factor driving at least some of the obesity-associated end-organ damage is overactivity of the sympathetic nervous system ( SNS ) , an observation that suggests that targeting SNS in obesity may help reduce the cardiovascular risk associated with obesity .
In this review , we highlight the current knowledge of the potential role of SNS function in obesity-induced organ damage and examine whether interventions aim ed at reducing cardiovascular risk in obesity may be mediated via alterations in SNS activity .