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Obese patients with heart disease live longer
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It is called the obesity paradox: overweight patients suffering from cardiovascular disease (CVD) that, against intuition, appear to have a much better long-term survival rate than their thinner counterparts. Scientists are now learning that even though obesity is a contributing factor to the cause of heart problems, the extra weight appears to have a protective function for those already suffering from the disease. However, doctors still believe maintaining a healthy weight is the best way to ensure a high quality of life.
A review article to be published in Journal of the American College of Cardiology surveys the obesity/CVD landscape. They’ve found that "obese patients with heart disease respond well to treatment and have paradoxically better outcomes and survival than thinner patients." [EurkeAlert]
Just what causes this strange relationship is unknown. Perhaps it is because those who are overweight show symptoms of CVD sooner, meaning physicians can catch the disease before it becomes an untreatable condition. Dr. Carl Lavie, medical director of Cardiac Rehabilitation and Prevention, Ochsner Medical Center in New Orleans believes “it is likely due to a combination of obesity's impact on fat cells and other metabolic processes (e.g., insulin resistance, glucose metabolism, metabolic syndrome), as well as other consequences of being obese…that excess weight may be somewhat protective because these patients have more reserves to fight disease than thinner patients.” [EurekAlert]
In some ways, this goes against the idea that thin immediately means healthy. On the other hand, it does not mean we should be striving to be overweight in order to protect ourselves from CVD. There is still the glaring fact that obesity causes CVD in the first place. Lavie is quick to note that "obesity is often what's causing high blood pressure, blockages in arteries, and increased risk of sudden death in the first place…Taken together, most studies are supportive of purposeful weight loss for preventing and treating cardiovascular disease." [EurekAlert] However, Investigation in why obesity offers some protection is underway, hopefully to the benefit of all that suffer from CVD.
According the press release, obesity is rapidly becoming the leading cause of preventable death, second only to tobacco use. "Obesity is skyrocketing in America and if this continues, we may see an unfortunate reversal to what has been a steady increase in life expectancy," says Dr. Lavie. [EurekAlert]
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