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Obesity-associated cardiovascular risk in women: hypertension and heart failure
1Physiology Department, Medical College of Georgia at Augusta University, Augusta, GA, U.S.A.
Insights
Obesity elevates cardiovascular disease risk, particularly hypertension and heart failure in women. These risks vary across reproductive stages, with pregnancy posing unique dangers, especially for women of African ancestry.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Reproductive Health
Background:
- Obesity is a significant risk factor for cardiovascular diseases (CVDs), preceding clinical events.
- Sex-specific differences exist in obesity prevalence and its impact on cardiovascular risk factors.
- Mechanisms of obesity-related CVD risk differ across women's reproductive stages (premenopause, pregnancy, postmenopause).
Purpose of the Study:
- To review clinical and experimental data on sex-specific hypertension and heart failure in women.
- To highlight obesity's role in cardiovascular risk across female reproductive stages.
- To emphasize risks during pregnancy and in women of African ancestry.
Main Methods:
- Review of clinical and experimental data.
- Focus on epidemiological trends and mechanistic insights.
- Analysis of data stratified by reproductive status and ethnicity.
Main Results:
- Obesity is strongly linked to hypertension and heart failure with preserved ejection fraction (HFpEF) in obese women across reproductive stages.
- Obesity increases risks for hypertension and heart failure during pregnancy.
- Data on women of African ancestry reveal specific high-risk profiles.
Conclusions:
- Obesity-associated cardiovascular risks, including hypertension and heart failure, are sex-dependent and vary with reproductive status.
- Pregnancy represents a critical period for heightened cardiovascular risk in obese women.
- Further research is needed on ethnicity-specific risks, particularly in women of African ancestry.
Abstract:
The pathogenesis of obesity-associated cardiovascular diseases begins long prior to the presentation of a cardiovascular event. In both men and women, cardiovascular events, and their associated hospitalizations and mortality, are often clinically predisposed by the presentation of a chronic cardiovascular risk factor. Obesity increases the risk of cardiovascular diseases in both sexes, however, the clinical prevalence of obesity, as well as its contribution to crucial cardiovascular risk factors is dependent on sex. The mechanisms via which obesity leads to cardiovascular risk is also discrepant in women between their premenopausal, pregnancy and postmenopausal phases of life. Emerging data indicate that at all reproductive statuses and ages, the presentation of a cardiovascular event in obese women is strongly associated with hypertension and its subsequent chronic risk factor, heart failure with preserved ejection fraction (HFpEF). In addition, emerging evidence indicates that obesity increases the risk of both hypertension and heart failure in pregnancy. This review will summarize clinical and experimental data on the female-specific prevalence and mechanisms of hypertension and heart failure in women across reproductive stages and highlight the particular risks in pregnancy as well as emerging data in a high-risk ethnicity in women of African ancestry (AA).
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