Related Experiment Video
Updated: Mar 31, 2026
En Face Detection of Nitric Oxide and Superoxide in Endothelial Layer of Intact Arteries
Published on: February 25, 2016
"Obesity paradox" in coronary artery disease
Ibrahim Akin1, Christoph A Nienaber1
1Ibrahim Akin, Department of Cardiology, Universitätsmedizin Mannheim, 68167 Mannheim, Germany.
Insights
Obesity is a growing public health concern linked to cardiovascular disease. This review examines the "obesity paradox," where obese patients sometimes show better outcomes, challenging current understanding.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Obesity presents a significant and escalating medical and socioeconomic burden globally.
- Morbid obesity is associated with major cardiovascular risk factors including hypertension, hyperlipidemia, and diabetes.
- Obese and overweight individuals constitute a substantial proportion of patients undergoing coronary revascularization.
Purpose of the Study:
- To review and critically evaluate the current evidence surrounding the "obesity paradox."
- To discuss the validity of the "obesity paradox" across various clinical contexts.
- To explore potential confounding factors and biases influencing the "obesity paradox" debate.
Main Methods:
- Comprehensive literature review of existing studies and population-based registries.
- Analysis of data correlating obesity with cardiovascular morbidity and mortality.
- Discussion of conflicting findings and methodological considerations in obesity research.
Main Results:
- Evidence indicates a positive correlation between obesity and increased cardiovascular morbidity.
- Some studies report a "obesity paradox," suggesting better clinical outcomes in overweight and obese patients.
- The validity and interpretation of the "obesity paradox" remain subjects of ongoing debate due to conflicting data and potential biases.
Conclusions:
- The "obesity paradox" in cardiovascular disease requires further rigorous investigation.
- Confounding biases may misrepresent the true clinical outcomes in obese patient populations.
- A nuanced understanding is needed to address the complex relationship between obesity and cardiovascular health.
Abstract:
Obesity used to be among the more neglected public health problems, but has unfolded as a growing medical and socioeconomic burden of epidemic proportions. Morbid obesity is linked to traditional cardiovascular risk factors like, hypertension, hyperlipidemia and diabetes, and suspected to incur increased morbidity and mortality in the Western and even third world populations. This patient cohort is also at greater risk to develop coronary artery disease. Recent population-based registries revealed that 43% and 24% of all cases of coronary revascularization were carried out in overweight and obese patients, respectively. However, despite evidence of a positive correlation between obesity and increased cardiovascular morbidity, some authors have described a better clinical outcome in overweight and obese patients, a phenomenon they coined "obesity paradoxon". Thus, there is an ongoing debate in light of conflicting data and the possibility of confounding bias causing misconception and challenging the "obesity paradox". In this review article we present the current evidence and throughly discuss the validity of the "obesity paradoxon" in a variety of clinical settings.
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:21Drug Dosing: Obese Patients
01:24Obesity
01:30Coronary Artery Disease III: Clinical Manifestations
01:25Pharmacokinetics in Obese Patients: Drug Absorption and Distribution