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Early markers of cardiovascular damage in obese subjects
G Licata1, R Scaglione, L J Dominguez
1Internal Medicine Department, University of Palermo, Italy.
Insights
Early cardiovascular changes like diastolic dysfunction and left ventricular hypertrophy can signal higher risk in individuals with obesity, hypertension, and diabetes. Identifying these markers aids in targeting preventive cardiovascular disease measures effectively.
Area of Science:
- Cardiology
- Preventive Medicine
- Metabolic Disorders
Background:
- Cardiovascular disease is a leading cause of death in industrialized nations.
- Hypertension, diabetes mellitus, and dyslipidemia are major risk factors, often linked to central obesity.
- Early detection of cardiovascular alterations is crucial for effective prevention.
Purpose of the Study:
- To identify early morphological and functional changes in the cardiovascular system.
- To highlight parameters indicative of early cardiovascular damage.
- To aid in targeting individuals who would benefit most from preventive strategies.
Main Methods:
- Review of literature data and expert experience.
- Analysis of early indicators such as diastolic dysfunction, left ventricular hypertrophy, and carotid plaques.
- Inclusion of markers like microalbuminuria and endothelial dysfunction.
Main Results:
- Diastolic dysfunction can precede clinical cardiac disease.
- Left ventricular hypertrophy is an early sign in hypertension, obesity, and diabetes.
- Carotid plaques may indicate concurrent coronary artery disease.
- Microalbuminuria and endothelial dysfunction are other early signs.
- Insulin resistance and renin-angiotensin-aldosterone system alterations are key in obese subjects.
Conclusions:
- Early cardiovascular changes, including diastolic dysfunction and left ventricular hypertrophy, precede overt clinical manifestations.
- These early markers are closely related to cardiovascular morbidity.
- Identifying these alterations helps pinpoint individuals at the highest risk for cardiovascular events.
Abstract:
Cardiovascular disease remains a frequent cause of morbidity and mortality in industrialized countries, particularly in subjects with hypertension, diabetes mellitus, and dyslipidemia, conditions frequently associated with central obesity. Identification of early morphological and/or functional alterations of the cardiovascular system may help target individuals most likely to benefit from preventive measures. The literature data and our own experience suggest that parameters that are direct expressions of cardiovascular damage, can be identified at an early stage. For example, diastolic dysfunction may precede the clinical expression of several cardiac diseases, left ventricular hypertrophy is one of the first manifestations of cardiac involvement in hypertension, central obesity and diabetes mellitus, and a carotid plaque may point to concomitant coronary artery disease. Other early manifestations of cardiovascular involvement are microalbuminuria and endothelial dysfunction. Insulin resistance and alterations of the renin-angiotensin-aldosterone system play an important physiopathogenic role in the development of cardiovascular damage in obese subjects, and their association with risk and cardiovascular disease has been confirmed in numerous studies. Since all these changes generally precede overt clinical manifestations and are closely related to cardiovascular morbidity, they may help identify individuals at the highest risk of cardiovascular events.