Cardiovascular risk in obese individuals: how to keep it under control?
Authors:
Ubomíra Fábryová 1,2,3,4
Authors‘ workplace:
Ústav výživy, Fakulta ošetrovateľstva a zdravotníckych odborných štúdií, Slovenská zdravotnícka univerzita v Bratislave
1; MetabolKLINIK s. r. o., Ambulancia pre diabetológiu, poruchy látkovej premeny a výživy, MED PED centrum, Bratislava
2; Biomedicínske centrum Slovenskej Akadémie Vied, Bratislava
3; Inštitút prevencie a intervencie, Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety, Bratislava
4
Published in:
AtheroRev 2025; 10(1): 33-37
Category:
Reviews
Overview
Obesity rates are increasing alarmingly year by year. It is well known that (pre)obesity exacerbates traditional cardiovascular risk factors and is also an independent cardiovascular risk factor, which in turn indirectly increases cardiovascular risk. The mechanisms that lead to the development of cardiovascular disease are multiple and not fully understood. However, evidence links obesity and chronic subclinical inflammation, which facilitates the development of atherosclerotic cardiovascular disease. (Pre)obesity increases morbidity and mortality from cardiovascular disease through direct and indirect mechanisms. Conversely, weight reduction is associated with significant health benefits and we now have evidence that more significant weight loss leads to more significant (not only) cardiometabolic benefits. The management of individuals with (pre)obesity is currently changing very rapidly due to new pharmacotherapies coming into clinical practice. If we want to improve cardiovascular morbidity and mortality in patients with (pre)obesity, we have to realize that the intervention must be early, vigorous and long-term. Our goal is to achieve not only safe, effective and sustainable weight reduction, which will lead to a decrease in the prevalence of obesity related comorbidities, but especially to a decrease in cardiovascular morbidity and mortality.
Keywords:
liraglutide – tirzepatide – cardiovascular mortality – (pre)obesity – cardiovascular morbidity – obesity-associated cardiovascular diseases
Sources
World Obesity Atlas. World Obesity Federation 2024. Dostupné z WWW: <https://www.worldobesity.org/news/world-obesity-atlas-2024>.
Eurostat 2024. Dostupné z WWW: <https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Overweight_and_obesity>.
Busetto L, Dicker D, Frühbeck G et al. A new framework for the diagnosis, staging and management of obesity in adults. Nat Med 2024; 30(9): 2395–2399. Dostupné z DOI: <https://doi.org/10.1038/s41591–024–03095–3>.
Powell-Wiley TM, Poirier P, Burke LE et al. Obesity and cardiovascular disease: a scientific statement from the American heart association. Circulation 2021; 143(21): e984–e1010. Dostupné z DOI: <https://doi.org/10.1161/CIR.0000000000000973>.
Volpe M, Borghi C, Cameli M et al. [Eight reasons why cardiologists should not overlook the problem “obesity”. Expert opinion for clinical practice]. G Ital Cardiol (Rome) 2023; 24(9): 677–691. Dostupné z DOI: <https://doi.org/10.1714/4084.40678>.
Fábryová Ľ. Obezita ako podhubie kardio-nefro-hepato-metabolických ochorení. In: Belovičová M, Moricová Š, Popovičová M et al. (eds). Obezita a metabolický syndróm. Zborník vedeckých prác. Collegium Humanum – Warsaw Management University, Warszawa 2023: 94–112. ISBN 978–83–964214–5-6.
Koskinas KC, Van Craenenbroeck EM, Antoniades C et al. [ESC Scientific Document Group]. Obesity and cardiovascular disease: an ESC clinical consensus statement. Eur Heart J 2024; 45(38): 4063–4098. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehae508>. Erratum in Correction to: Obesity and cardiovascular disease: an ESC clinical consensus statement. Eur Heart J 2025: ehae915. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehae915.
Whitlock G, Lewington S, Sherliker P 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. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(09)60318–4>.
Csige I, Ujvárosy D, Szabó Z et al. The Impact of Obesity on the Cardiovascular System. J Diabetes Res 2018; 2018: 3407306. Dostupné z DOI: <http://dx.doi.org/10.1155/2018/3407306>.
Perone F, Spadafora L, Pratesi A et al. Obesity and cardiovascular disease: Risk assessment, physical activity, and management of complications. Int J Cardiol Cardiovasc Risk Prev 2024; 23: 200331. Dostupné z DOI: <https://doi.org/10.1016/j.ijcrp.2024.200331>.
Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism 2019; 92: 98–107. Dostupné z DOI: <http://dx.doi.org/10.1016/j.metabol.2018.10.011>.
Fábryová Ľ. Obezita, diabetes mellitus (diabezita) a kardiovaskulárne ochorenia: nebezpečná metabolická triáda. Forum Diab 2019; 8(3): 178–183.
Mandviwala T, Khlaid U, Deswal A. Obesity and Cardiovascular Disease: a Risk Factor or a Risk Marker? Curr Atheroscler Rep 2016; 18(5): 21. Dostupné z DOI: <http://dx.doi.org/10.1007/s11883–016–0575–4>.
Elagizi A, Kachur S, Milani V et al. An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases. Prog Cardiovasc Dis 2018; 61(2): 142–150. Dostupné z DOI: <http://dx.doi.org/10.1016/j.pcad.2018.07.003>.
Kim SH, Despres JP, Kon KK. Obesity and cardiovascular disease: friend or foe? Eur Heart J 2016; 37(48): 3560–3568. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehv509>.
Marso SP, Daniels GH, Brown-Frandsen K et al. [LEADER Steering Committee; LEADER Trial Investigators]. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016; 375(4): 311–322. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1603827>.
Verma S et al. Improvement of the 10-year AS CVD risk with once-weekly semaglutide 2,4 mg in adults with overweight or obesity – post hoc analysis of the STEP 1 trial. J Am Coll Cardiol 2021; 77(18_Suppl 1): 1606. Dostupné z DOI: <https://doi.org/10.1016/S0735–1097(21)02963–6>.
Kosiborod MN, Abildstrøm SZ, Borlaug BA et al. [STEP-HFpEF Trial Committees and Investigators]. Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity. N Engl J Med 2023; 389(12): 1069–1084. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2306963>.
Solomon SD, Ostrominski JW, Wang X et al. [STEP-HFpEF Trial Committees and Investigators]. Effect of Semaglutide on Cardiac Structure and Function in Patients With Obesity-Related Heart Failure. J Am Coll Cardiol 2024; 84(17): 1587–1602. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2024.08.021>.
Jastreboff AM, Aronne LJ, Ahmad NN et al. [SURMOUNT-1 Investigators]. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med 2022; 387(3): 205–216. <Dostupné z DOI: http://dx.doi.org/10.1056/NEJMoa2206038>.
Rodriguez PJ, Goodwin Cartwright BM, Gratzl S et al. Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity. JAMA Intern Med 2024; 184(9): 1056–1064. Dostupné z DOI: <http://dx.doi.org/10.1001/jamainternmed.2024.2525>.
Packer M, Zile MR, Kramer CM et al. [SUMMIT Trial Study Group]. Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity. N Engl J Med 2024. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2410027>.
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