Obesity and Cardiovascular Disease.

Area of Science:

• Cardiovascular Health
• Metabolic Health
• Obesity Research

Background:

• Global obesity prevalence has surged, exceeding 50% in some regions and posing significant public health concerns due to its strong link with cardiovascular disease (CVD).
• Obesity, particularly severe obesity, is consistently associated with increased CVD incidence and mortality.
• Individual CVD prognosis in obese populations varies, necessitating a nuanced approach beyond a one-size-fits-all strategy.

Purpose of the Study:

• To review current evidence on the relationship between obesity and cardiovascular disease (CVD).
• To explore factors influencing CVD prognosis in obese individuals, including the fat-but-fit paradigm, metabolically healthy but obese (MHO) phenotype, and the obesity paradox.
• To propose a harmonized definition for the MHO phenotype to improve future research and understanding.

Main Methods:

• Comprehensive review of existing scientific literature on obesity and cardiovascular disease.
• Analysis of studies examining the association between obesity, metabolic health, and CVD outcomes.
• Discussion of confounding factors and challenges in defining the MHO phenotype.

Main Results:

• Obesity is a major risk factor for CVD incidence and mortality.
• The metabolically healthy but obese (MHO) phenotype presents mixed findings regarding CVD prognosis, potentially due to inconsistent definitions and confounding variables like cardiorespiratory fitness.
• Existing research lacks a consensus definition for MHO, hindering comparable data analysis.

Conclusions:

• A harmonized, scientifically-based definition of the MHO phenotype is proposed to facilitate consistent research.
• Better understanding of the MHO subgroup is crucial for accurate CVD risk assessment and management.
• Future research should focus on standardized definitions and robust methodologies to clarify the CVD prognosis associated with different obesity phenotypes.