[Body mass index and cardiovascular events: the "obesity paradox"].
Excessive body mass among healthy subjects carries an increased risk of subsequent cardiovascular events. Excess weight implies the presence of white, viscero-abdominal fat, that promotes insulin-resistance, is infiltrated by macrophages, and is less differentiated compared to subcutaneous or brown fat. Conversely, among patients with cardiovascular disease, slim patients have a greater risk of recurrent atherothrombotic events than fatter patients ("obesity paradox"). Lean patients with cardiovascular disease, on average, have more comorbidities and haemorrhagic complications than their heavier counteparts, and probably they conceal predisposing factors that are still unknown and therefore difficult to treat.
Andreotti
Felicita
F
Istituto di Cardiologia, Dipartimento di Medicina Cardiovascolare, Policlinico Universitario A. Gemelli, Roma. felicita.andreotti@iol.it
Rio
Teresa
T
Lavorgna
Alberto
A
Coluzzi
Giulio
G
Santucci
Eleonora
E
Cecchetti
Silvia
S
Pennestrì
Faustino
F
Crea
Filippo
F
D000273:Adipose Tissue / Q000378:metabolism; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D012307:Risk Factors