Obesity in Cardiovascular disease

people globally had cardiovascular disease in 2019.¹

That’s almost twice the number of cases in 1990.¹

of people with cardiovascular disease live with overweight or obesity.²

Cardiovascular diseases (CVDs) are the primary consequence of dietary risks with 7.94 million annual deaths attributed to dietary risks including obesity and overweight.¹

Every 40 seconds, someone in the United States experiences a heart attack³ or stroke.⁴

People with a Body Mass Index (BMI) of 25.0-29.9 kg/m² or over have an increased risk of developing hypertension.⁵

In addition, overweight and obesity increase the risk of hypertension, dyslipidemia, and type 2 diabetes.⁵

For every 5 kg/m² BMI increment above the range of 22.5 to 25 kg/m², there is a 30% increase in overall mortality.⁶

Living with obesity increases the risk of developing CVD

Source - adapted from figure 3(d) in GBD Obesity Collaborators, et al. 2015.⁷

The need for early intervention while treating obesity

813 million adults live with obesity and by 2035, this number is projected to rise to 1.5 billion.⁸ Obesity is associated with over 200 complications including stroke, cholesterol, type 2 diabetes, hypertension, and atherosclerosis.⁹

The Atherosclerosis Risk in Communities study implies that 17.9% of the risk incident of atrial fibrillation was attributed to obesity.¹⁰

Source - adapted from figure 1 in Cardiovascular Outcome Trials in Obesity. 2021.¹¹

Weight loss is also associated with improvements in CVD risk factors and adverse CV events. According to a post-hoc analysis from the Look AHEAD trial, individuals with type 2 diabetes who lost ≥10% body weight had a 21% decrease in 4-point MACE incidence (defined as CV death, non-fatal acute myocardial infarction, non-fatal stroke, or hospitalisation for angina).¹²

A weight loss of 5% has significant health benefits, and a sustained weight loss of 10–15% or more can further enhance these benefits and provide additional improvements to health.^12-23

The effect of weight loss on cardiovascular risk

Source - adapted from table 5 in Schutz D, et al. European Guidelines for Adult Obesity Management. 2019²⁵

In 2030, an estimated one billion individuals could be affected by obesity, potentially increasing the risk of cardiovascular diseases, making addressing obesity of paramount importance.⁸

Cardiovascular diseases (CVDs) are the leading cause of death globally.²⁵ Of these deaths, 7.4 million were due to heart attack, and 6.7 million due to stroke.²⁵

The number of people experiencing cardiovascular disease, including a heart attack and stroke, has increased by 24.6% over the past decade.²⁶

The past half century has witnessed remarkable and unexpected progress, including a global action plan for the prevention of non-communicable diseases (NCDs) including heart attack and stroke.²⁵ Even with this progress, heart attack and stroke remain the leading causes of death.²⁵

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Gregory A Roth et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019. J Am Coll Cardiol. 2020. Available at: https://doi.org/10.1016/j.jacc.2020.11.010

Kotseva et al. “Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry.” European journal of preventive cardiology vol. 26,8 (2019): 824-835. doi:10.1177/2047487318825350

Tsao et al. Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association. Circulation. 2023;147:e93–e621.

Centre for Disease Control and Prevention (CDC). Stroke Facts. Available at: https://www.cdc.gov/stroke/facts.htm Last Accessed: September 2023.

Powell-Wiley, Tiffany M., Paul Poirier, Lora E. Burke, Jean-Pierre Després, Penny Gordon-Larsen, Carl J. Lavie, Scott A. Lear, et al. “Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association.” Circulation 143, no. 21 2021. https://doi.org/10.1161/cir.0000000000000973.

Whitlock G, Lewington S, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083-1096. doi:10.1016/S0140-6736(09)60318-4

GBD 2015 Obesity Collaborators et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med 2017;377:13-27. DOI:10.1056/NEJMoa1614362

World Obesity Federation. World Obesity Atlas 2023. Available at: https://www.worldobesity.org/resources/resource-library/world-obesity-atlas-2023 Last accessed: June 2023.

Horn, D. B., Almandoz, J. P., & Look, M. What is clinically relevant weight loss for your patients and how can it be achieved? A narrative review. Postgraduate medicine (2022), 134(4), 359–375

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Nalliah CJ et al. The role of obesity in atrial fibrillation. European Heart Journal. 2016;37(20):1565–1572. Available at: https://doi.org/10.1093/eurheartj/ehv486. Last Accessed June 2023.

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Wilding, JPH, Jacob, S. Cardiovascular outcome trials in obesity: A review. Figure 1. Obesity Reviews. 2021; 22:e13112.

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Look AHEAD Research Group. Association of the magnitude of weight loss and changes in physical fitness with long-term cardiovascular disease outcomes in overweight or obese people with type 2 diabetes: a post-hoc analysis of the Look AHEAD randomised clinical trial. Lancet Diabetes Endocrinol. 2016; 4:913-921

13.

Ryan D and Yockey S. Weight loss and improvement in comorbidity: Differences at 5%, 10%, 15%, and over. Curr Obes Rep. 2017; 6:187–194.

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Wing RR, Lang W, Wadden TA, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34:1481–1486.

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Dattilo AM and Kris-Etherton PM. Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis. Am J Clin Nutr. 1992;56:320–328.

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Coggon D, Reading I, Croft P, et al. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord. 2001;25:622–627.

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Zelber-Sagi S, Godos J and Salomone F. Lifestyle changes for the treatment of nonalcoholic fatty liver disease: a review of observational studies and intervention trials. Therap Adv Gastroenterol. 2016;9:392–407.

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Glass LM, Dickson RC, Anderson JC, et al. Total body weight loss of >/= 10 % is associated with improved hepatic fibrosis in patients with nonalcoholic steatohepatitis. Dig Dis Sci. 2015;60:1024–1030.

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Garvey W, Mechanick J, Brett E, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016; 22(Suppl 3):1–203.

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Benraoune F and Litwin S. Reductions in cardiovascular risk after bariatric surgery. Curr Opin Cardiol. 2011; 26:555–561.

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