Potential benefits of weight loss in coronary heart disease.
The prevalence of overweight, obesity and insulin resistance in patients with coronary heart disease (CHD) exceeds that of the general population. Obesity is associated with a constellation of coronary risk factors that predispose to the development and progression of CHD. Intentional weight loss, accomplished through behavioral weight loss and exercise, improves insulin sensitivity and associated cardio-metabolic risk factors such as lipid measures, blood pressure, measures of inflammation and vascular function both in healthy individuals and patients with CHD. Additionally, physical fitness, physical function and quality of life all improve. There is evidence that intentional weight loss prevents the onset of CHD in high risk overweight individuals. While weight loss associated improvements in insulin resistance, fitness and related risk factors strongly supports favorable prognostic effects in individuals with established CHD, further study is needed to determine if long-term clinical outcomes are improved.
Division of Cardiology, University of Vermont College of Medicine, Burlington,VT05403. Electronic address: Philip.Ades@vtmednet.org.
Philip A
PA
Ades
Division of Cardiology, University of Vermont College of Medicine, Burlington,VT05403.
Patrick D
PD
Savage
D015992:Body Mass Index; D003327:Coronary Disease / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000517:prevention & control; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control; D010809:Physical Fitness; D015995:Prevalence; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D015431:Weight Loss / Q000502:physiology*
BMI; BWL; Behavioral weight loss; Body mass index; C-reactive protein; CHD; CR; CRP; CV; Cardiac rehabilitation; Cardiovascular; Coronary heart disease; Coronary risk factors; HDL; High- density lipopoprotein; LDL; Low-density lipoprotein; MetS; Metabolic syndrome; PA; PAI-1; Physical activity; Plasminogen activator inhibitor-1; Prognosis; T2DM; Type 2 diabetes mellitus; Weight loss