'Healthy' Obese People Are Still At Higher Risk Of Cardiovascular Disease

Obese people with no metabolic abnormalities such as high cholesterol levels, hypertension, diabetes are also at risk of heart diseases.

People with metabolically healthy obesity (MHO) are clinically obese in terms of their body mass index (BMI) (more than 30 kg/m2), but do not have metabolic complications that usually come with obesity, such as abnormal blood fats, poor blood sugarcontrol or diabetes, and high blood pressure.

The study done by Dr Rishi Caleyachetty and colleagues at The Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, UK finds that the so called 'metabolically healthy' obese people are still at higher risk of cardiovascular disease events such as heart failure or stroke than normal weight people.

Congestive Heart Failure (Congestive Cardiac Failure) Current Management
Congestive heart failure (CHF) is a condition in which the heart fails to work adequately as a pump that can deliver oxygen rich blood to the body.

‘'Metabolically healthy' obese people are still at higher risk of cardiovascular disease events such as heart failure or stroke than normal weight people.’

Whether MHO is associated with excess risk of cardiovascular disease (CVD) events is a subject of debate. Important limitations in the evidence to date include inconsistent definitions of metabolic health, inconsistent control for other factors (confounders), and small sample sizes. In this new study, the authors address these limitations in a large contemporary cohort, based on linked primary care electronic health records.

The researchers used linked electronic health records from 1995 to 2015 in The Health Improvement Network (THIN) -- a large UK database of general practice records -- to assemble a cohort of 3.5 million individuals aged 18 years or older and initially free from CVD.

To determine metabolic health, they divided the population into groups according to BMI and the presence or absence of 3 metabolic abnormalities (diabetes, high blood pressure [hypertension], and abnormal blood fats [hyperlipidemia]) which were added together to create a metabolic abnormalities score (0, 1, 2 and 3). To be classified as MHO, individuals had to have none of these metabolic abnormalities.

Obesity - Causes, Symptoms, Diagnosis, Complications, Treatment
Obesity is a condition where there is excess accumulation of body fat which poses a risk to the health of the individual. It can affect children and adults.

The study examined whether the risk of developing four cardiovascular conditions (coronary heart disease (CHD), cerebrovascular disease (transient ischaemic attack or stroke), heart failure, and peripheral vascular disease (PVD)] was different for normal weight people with no metabolic conditions or people with MHO.

The authors found that, compared to normal weight individuals with no metabolic abnormalities, individuals with MHO had a 50% increased risk of CHD; a 7% increased risk of cerebrovascular disease and a doubled risk of heart failure, (all statistically significant), after taking into account demographics and smoking behavior. Against these trends, MHO individuals had a 9% lower risk of PVD.

Carbohydrates and Its Role in Obesity
Over 1 billion people world-wide are obese thus affecting their health due to their nutrition and lifestyle. 3.9% of India’s population is obese! Know more about obesity and its prevention.

However, in further analyses that excluded cigarette smokers, individuals with MHO had a significantly (11%) increased risk of developing PVD compared with those with normal weight and zero metabolic abnormalities.

The analysis also showed that the risk of CVD events in obese individuals increased with increased number of metabolic abnormalities present.

Pulmonary Edema - Causes, Symptoms, Signs, Diagnosis, Treatment, Prevention
Pulmonary edema or fluid in the lungs is caused by congestive heart failure and several other conditions, including pneumonia, exposure to certain toxins etc.

For example, compared to a normal weight person with zero metabolic abnormalities, an obese person with 3 metabolic abnormalities had a 2.6 times increased risk of CHD; a 58% increased risk cerebrovascular disease including stroke; a 3.8 times increased risk of heart failure, and a 2.2 times increased risk of PVD.

Dr Caleyachetty says: "This is the largest prospective study of the association between metabolically health obesity and cardiovascular disease events. Metabolically healthy obese individuals are at higher risk of coronary heart disease, cerebrovascular disease and heart failure than normal weight metabolically healthy individuals. The priority of health professionals should be to promote and facilitate weight loss among obese persons, regardless of the presence or absence of metabolic abnormalities."

He adds: "At the population-level, so-called metabolically healthy obesity is not a harmless condition and perhaps it is better not to use this term to describe an obese person, regardless of how many metabolic complications they have."

Source-Eurekalert