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Review
. 2019 Aug 28:11:74.
doi: 10.1186/s13098-019-0468-0. eCollection 2019.

Cardiovascular risk and obesity

C Cercato  1 , F A Fonseca  2
Affiliations
Review

Cardiovascular risk and obesity

C Cercato et al. Diabetol Metab Syndr. .

Abstract

Background: This is an overview of the mechanisms of obesity and its relation to cardiovascular risks, describing the available treatment options to manage this condition.

Main body: The pathogenesis of obesity includes the balance between calories consumed and energy expenditure followed by the maintenance of body weight. Diet, physical activity, environmental, behavioral and physiological factors are part of the complex process of weight loss, since there are several hormones and peptides involved in regulation of appetite, eating behavior and energy expenditure. The cardiovascular complications associated to obesity are also driven by processes involving hormones and peptides and which include inflammation, insulin resistance, endothelial dysfunction, coronary calcification, activation of coagulation, renin angiotensin or the sympathetic nervous systems. Pharmacological treatments are often needed to insure weight loss and weight maintenance as adjuncts to diet and physical activity in people with obesity and overweight patients.

Conclusion: To accomplish satisfactory goals, patients and physicians seek for weight loss, weight maintenance and improvement of the risk factors associated to this condition, especially cardiovascular risk.

Keywords: Cardiovascular risk; Clinical assessment; Obesity.

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Conflict of interest statement

Competing interestsFF has served as steering committee member for Novartis and Astra Zeneca, and reports having received research grants, lecture fees, and consulting fees from AstraZeneca, Bayer, Sanofi-Aventis, Novo Nordisk, Novartis, Takeda, Amgen, Biolab, Ache, EMS, and Merck. CC has served as advisory board for Eurofarma and Novo NordisK, and reports having received research grants from AstraZeneca, Sanofi-Aventis, Novo Nordisk, Eurofarma, Fractyl, Lilly, Boehringer Ingelheim, and Abbvie. The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Process of inflammation in obesity. Inflammatory infiltrate into adipocyte cells is a common finding in subjects with obesity or metabolic syndrome and an inflammatory status can be detected by circulating biomarkers. In addition, an increased in the amount of reactive oxygen species (ROS) and reactive nitrogen species (RNS) can also be detected. In parallel, disturbances in the microbiota are related to increased lipopolysaccharide (LPS) release in the bloodstream which activates toll like receptor 4 (TLR4). Finally, increased perivascular adipose tissue promotes local inflammation and impairment of endothelium function
Fig. 2
Fig. 2
Relationship of obesity and cardiovascular risk. GLP-1 glucagon-like peptide 1, RAS renin angiotensin system
See this image and copyright information in PMC

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