The Effects of Obesity on the Heart

Heart disease is the leading killer of men and women in the United States accounting for almost a quarter of all deaths in the US in 2008. Unlike many other diseases, cardiovascular disease is well known, predictable and often preventable with simple and straightforward lifestyle change.

The simple fact is that obesity and excess weight contribute to heart disease in a very significant way. Not only can excess weight, on its own, cause an increased risk of heart disease, but its comorbid (related) conditions can too. Further, those who are obese often exercise less and eat foods that are higher in fats and sugars. This, in turn, increases the risk of heart disease. And while obesity is a reversible and ultimately preventable disease, many cardiovascular issues are not, leading to compromised lifestyle and premature death.

High Blood Pressure or Hypertension

One of the most common effects of obesity is high blood pressure, which occurs when the blood pumping out of the heart pushes against the walls of the arteries with greater force than normal. This pressure causes the heart to work harder, which, over time, can enlarge and weaken it significantly. This weakening and enlargement is known as congestive heart failure. High blood pressure can also increase the risk of damage to your arteries and brain and can cause a stroke or aneurysm. While high blood pressure is treated with the use of drugs, such as ACE Inhibitors and Beta Blockers, these medications do not treat the underlying cause of the problem, which, in many cases, is obesity.

High Cholesterol

Those suffering from excess weight or obesity are at a greater risk for high cholesterol, specifically high LDL or bad cholesterol and triglycerides. High cholesterol is a significant contributory factor to coronary heart disease and buildup of plaque in the arteries. While high cholesterol can be managed through medications, common medications, such as statins, do not treat the source of the issue.

Coronary Heart Disease

By promoting the buildup of dangerous plaques on the walls of the coronary arteries, obesity drastically increases the risk of coronary heart disease. As these sticky plaques build, the arteries are narrowed and less blood is transported back into the heart. The initial presentation of this condition can be angina, or chest pain, and if left untreated it can create a higher risk of heart attack. Lifestyle changes including weight loss are most effective at preventing Coronary Heart Disease, however angioplasty, stenting or even bypass surgery may be necessary if the disease has progressed too far.

Patients with coronary heart disease are at a greater risk of follow-on heart failure. This means that the pumping mechanism of the heart (a muscle) begins to weaken and the heart is not able to pump enough blood back to the rest of the body. This is a treatable, but incurable disease.

Atrial Fibrillation (AFib)

Over 5 million people in the United States are affected by atrial fibrillation, a common arrhythmia that not only causes compromise in lifestyle, but can also increase the risk of stroke. A recent study, presented at the American College of Cardiology’s 2015 scientific session showed that patients that lost weight, At least 10% of their bodyweight, had a six times greater chance to be free of AFib versus those who did not lose weight.

Stroke

A stroke occurs when blood clots reduce the amount of oxygen that is transported to the brain. As we gain weight and reach obesity levels, the buildup of plaque in our arteries can lead to blood clots. Strokes can occur with little or no notice, creating a high risk of permanent impairment or death. Obesity has a direct correlation with risk of stroke. Further, those with atrial fibrillation (potentially caused by obesity) are also at a significantly higher risk of stroke.

Type 2 Diabetes

Many obese patients also suffer from high blood glucose or type II diabetes. Type 2 diabetes is also known as adult onset diabetes since it is acquired, usually in adulthood. Over the course of time, as our intake of sugar is too high, the pancreas tries to regulate blood sugar by secreting more insulin. However, patients with type-2 diabetes cannot properly use the insulin produced. This is called insulin resistance. Eventually, the pancreas cannot keep up, which requires medical treatment to control sugar levels. Diabetes, in turn, can cause coronary heart disease, stroke, kidney disease, blindness, diabetic neuropathy and more. Medications and insulin tablets and injections are used to control type 2 diabetes; however, they can become less effective over time.

Beyond a simple BMI calculation, you and your doctor should discuss your waistline, as excess fat around the abdomen is a leading indicator of heart disease. Women with a waist circumference of greater than 35 and men with a circumference of more than 40 inches are at a significantly increased risk of cardiovascular disease.

Every patient is different, but the one common factor is that even losing a small amount of weight can make a big difference in heart disease risk. Patients who lose 10 or more percent of their body weight are likely to see dramatic beneficial effects in the form of improvements in many of the conditions shown above.