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Obesity and Heart Diseases

There are three ways that obesity contributes to cardiovascular disease:

1 – Elevation in cholesterol levels, increase LDL (bad cholesterol), and TG but drop HLD (good cholesterol).

2 – Elevation of blood pressure, because obese people need more blood to supply oxygen and nutrients to the body.

3 – Can lead to diabetes, 68% diabetic patient over 65 also have heart disease.

I - Atherosclerosis: it is known that obesity and atherosclerosis are a lipid storage disorders and now obesity and atherosclerosis are considered chronic inflammatory conditions where activation of nonspecific and adaptive immune processes is assigned a significant role.

 There is a lot of research about the role of inflammation in the progression of atherosclerosis

II - Coronary artery disease: obesity is the most important risk factor, ahead of smoking for heart attack (NSTEMI, STEMI) in young people. If you are obese for more than 20 years it considers as risk factor for ischemic heart disease. We know that atherosclerosis begins several decades before it manifests by angina or heart attack.

Increase your weight 10 kg rises the risk of coronary artery disease by 12%.

III - Heart failure: it was noticed there is close correlation between heart failure and obesity. Framingham Heart Study showed, the rise of BMI 1 kg/m2 increase the risk of heart failure by 5% in men and 7% in women. About 31-40% of people with heart failure are overweight and 32-49% of them are obese, so for those people heart failure develops 10 years earlier than normal BMI people.

The mechanism can be direct and indirect such as:

  • Rise cardiac output and blood pressure,
  • Activation of the renin-angiotensin-aldosterone system,
  • Activation of sympathetic nervous system,
  • Platelet aggregation, and endothelial dysfunction,
  • Rise in Inflammatory cytokines (TNF-a, IL-1, IL-8,..)
  • Associated medical condition with obesity as diabetes and hypertension and hyperlipidemia.

IV - Cardiac arrhythmia: Hippocrates concluded in the 4th century that “sudden death is more common in those who are naturally fat than in the lean”.

I - Atrial fibrillation, many studies showed correlation between obesity and atrial fibrillation:

  • Obese patients have a 1:52 times higher risk to get atrial fibrillation than normal weight patients.
  • Epicardial pad which is full by fat contributes to the development of atrial interstitial fibrosis and then dilatation and dysfunction.
  • the low-grade inflammation (presence of various cytokines, CRP, interleukin-6 and tumor necrosis factor) in obese people is assumed to be underlining cause for atrial fibrillation.
  • There is correlation between atrial fibrillation and the Increase atrial natriuretic peptide.

II - Sudden cardiac death: many studies showed some relation between sudden cardiac death and obesity, most probably due to ventricular tachyarrhythmia triggered by obesity. Obesity also can cause prolong QT due to structural remodeling in the ventricular myocardium which precipitate to ventricular dysfunction and heart failure. The pathogenesis may be myocardial hypertrophy, fibrosis, and increase epicardial fat (obesity cardiomyopathy).

V - Hemodynamic changes triggered by obesity: which predispose hypertension due to structural and functional changes in the heart associated with obesity,

- Structural changes included Left ventricular hypertrophy then dilation, so heart failure, epicardial fat accumulation, and left atrial dilatation occur.

- Functional changes included increase blood volume and high cardiac output by increase stroke volume and less degree by tachycardia enhanced by sympathetic tone.

CARDIOLOGY PACKAGES

Consultation + ECG + Echocardiography 

1360 AED

Consultation + ECG + Echocardiography + Stress Tests

2832.5 AED

Stress Tests + Consultation 

2266 AED

 

Dubai Cardiology clinic at Dr Rami Hamed Center provides you one of the best cardiology doctors in Dubai or best heart doctor in Dubai for treating hypertension, heart failure, ischemic heart disease, holter monitoring, stress test, chest pain and echocardiography .DRHC is considered as one of the best heart hospital in Dubai  and also has the best pediatric cardiologist in Dubai

DR. M.ADIB NANAA (1)

Dr. M. Adib Nanaa

Specialist Cardiologist

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