Artham, Surya M.; Lavie, Carl J.; De Schutter, Alban; Ventura, Hector O.; Milani, Richard V.
Abstract
Obesity is a highly prevalent metabolic disorder affecting all sections of society from young children to adults and the elderly. Obesity is a well-established risk factor for several conventional cardiovascular (CV) risk factors such as hypertension (HTN), type 2 diabetes mellitus, and dyslipidemia. Obesity is also a very potent independent risk factor for CV diseases (CVD), including coronary heart disease (CHD), heart failure (HF), peripheral arterial disease (PAD), atrial fibrillation (AF), and sudden cardiac death (SCD), and is also associated with increased CV and all-cause morbidity. Despite this adverse association between obesity and CV risk factors and several CVDs, numerous studies have identified the phenomenon called the "obesity paradox" or "reverse epidemiology", meaning better short-and long-term survival in overweight and obese subjects with HTN, HF, CHD, PAD, and AF. This review summarizes the adverse impact of obesity on CV risk factors and CVDs, effects of obesity and aging in the elderly, and the puzzling phenomenon of the "obesity paradox" in the above-mentioned special populations and the elderly.