Obesity Heart Problems: Obesity and Cardiovascular Diseases are two such terms which you will always find connected to each other. Obesity is a condition where a person has accumulated so much body fat that it might have a negative effect on their health. There is a strong risk of developing cardiovascular disease if a person is obese or overweight. Obesity is among the leading causes of elevated cardiovascular disease (CVD) mortality and morbidity.
Cardiovascular Diseases can be divided into two broad groups:
Cardiac Diseases - Cardiac diseases mainly include:
- Angina / Heart Attack
- Arrhythmia (Missed or increased number of heart beat)
- Congestive Cardiac Failure (CCF)
- Cardiac Myopathies
Vascular Diseases - Vascular Diseases are in itself grouped into two categories:
- Arterial anomalies – Hypertension etc
- Vein related anomalies – Varicose Veins etc
Obesity has a great role in aggravating and worsening both Cardiac and Vascular diseases
Prevalence of Obesity
- The prevalence of obesity is similar for both men and women.
- More than one-third of adults are considered to be obese.
- More than 1 in 20 have extreme obesity.
- Almost 3 in 4 men are considered to be overweight or obese.
Types of Obesity:
- Inactivity Obesity
- Food Obesity
- Anxiety Obesity
- Venous Obesity
- Atherogenic Obesity
- Gluten Obesity
What are the complications of obesity?
Atherosclerosis is a condition in which there is deposition of cholesterol in arteries due to the overall rise of LDL (low-density lipids) in blood. This deposition of cholesterol in arteries is known as plaque formation. Formation of the plaques decreases the size of the lumen of the artery. This leads to the improper or complete cessation of the supply of blood to muscles and this whole process ultimately results in cell death. Atherosclerosis of coronary arteries (arteries supplying blood to heart muscles) leads to decreased perfusion of cardiac muscle which causes muscle fatigue and finally muscle death.
Deposition of cholesterol in blood vessels can worsen the already existing anomalies. A person who is suffering from Hypertension or who are taking Nicotine in any form develop roughness in their blood vessel lumen. This roughness leads to cholesterol deposition. Cholesterol deposition leads to improper blood flow to the heart muscles which results in Angina or Acute chest pain. Angina can occur when a person with underlying heart condition perform the heavy exercise. Heavy exercise increases the demand for oxygen by the muscles. This requirement is not met as there is an improper supply of blood due to blockage in the arterial lumen.
Myocardial Infarction or Heart Attack is a condition which occurs due to rupture of the blood vessels. Blood vessels rupture when a person performs heavy exercise. In this condition, there is a total cessation of blood supply to the heart muscles. This complete blood supply cut off results in muscle death which is an irreversible process.
In this condition, the heart has to pump more blood to fulfill the requirement due to which there is an increase in the size of the cells of the heart which is also known as Left Ventricular Hypertrophy. This heals with fibrosis which makes the Left Ventricle or the main chamber of the heart hard. This decreases the volume of the blood pumped by the heart. This condition is represented as breathlessness, tiredness, dyspnoea (difficulty in breathing), swollen feet.
3 .Insulin Resistance
We all have a busy schedule which we have to follow every day and at the end of the day, we are left with no time for any kind of physical activity. We all love eating junk food which contains a high level of carbohydrates which you can also call the ‘bad carbohydrate’. These carbohydrate gets digested in our body and produces glucose. Normally if there is an increase in the level of glucose in the blood than normal, insulin comes into action and get the extra glucose to deposit in liver and muscles and normalizes the level of glucose in the blood. But due to a sedentary lifestyle and genetic predisposition the person gets obese and the fat cells from the body releases some chemicals like adipokines and cytokines inhibits insulin and this condition is known as insulin resistance. To tackle this situation Pancreas increase the secretion of insulin this results in insulinemia or increased level of insulin in the blood. This insulin is a lipogenic hormone which converts glycogen into lipids and makes this lipid deposit in the abdominal area. Chemicals like adipokines and cytokines don’t let glucose to deposit in liver and muscle and therefore the level of glucose remain raised in the blood which may lead to diabetes. This all happens due to decreased HDL and increased Triglycerides which leads to central obesity, Hypertension, and Insulin Resistance. This whole process is known as Syndrome X or Metabolic Syndrome.
As we have already discussed that there is a great increase in the level of insulin due to presence of fat cells in the body. Increased insulin level doesn’t allow the kidney to excrete salt or Sodium ions in urine. This causes retention of Sodium ions or salt in the body which leads to edema and hypertension. Insulin evokes sympathetic system of the body which increases the Heart Rate and Blood Pressure which is nothing else but Hypertension. Therefore more you eat more will be your Heart Rate and Blood Pressure.
What are the other complications which can be faced by an overweight person?
- Heart problems
- Musculoskeletal problems
- Gall bladder stones
- Fatty Liver
- Gastroesophageal Reflux Disease (GERD)
- Postmenopausal related Breast Cancer
- Hormonal problem – PCOS, Infertility
- Obstructive Sleep Apnoea (OSA)
How do I know if I'm overweight or not?
There is a simple formula which one can use to know whether they are overweight or not.
BMI (Body Mass Index) = Weight in kilograms / (Height in metres) ²
- BMI > 23 Indicates that the person is overweight
- BMI > 25 Indicates that the person is obese
BMI is the gold standard formula to know in which category you fall.
More the value of BMI more are the chances of developing cardiovascular disease and other complications. Being a gold standard BMI is also controversial as it can’t differentiate between muscle mass and fat percentage.
What are the other parameters to measure Obesity?
Normal waist circumference for females: < 80 cm
Normal waist circumference for males: < 90 cm
Waist - Hip Ratio
Waist – Hip Ratio is the dimensionless ratio of the circumference of the waist to that of the hips.
Waist - Height Ratio
The waist-to-height ratio is more sensitive than BMI as an early warning of health risks.
What are the investigations which one should go for to confirm Obesity?
- Renal Function Test
- Liver Function Test
- Complete Blood Count
- Fasting Plasma Glucose
- Lipid Profile
- Serum Leptin
- Coagulation profile
- Arterial blood gas
- Thyroid function test
- Pulmonary function test
- Upper GI endoscopy
- Sleep studies
- Ultrasound abdomen
It mainly aims at cutting down bad carbohydrates from diet and intake of a balanced diet which is high in complex carbohydrates.
One should follow a proper workout routine including cardio exercises, walk of at least one hour. The more you sweat the more you lose weight. Increased physical activity in overweight and obese adults helps a lot in losing weight. It also increases cardio respiratory fitness and reduces the risk of cardiovascular disease.
Behavioral treatment is an approach which helps obese individuals to identify what all changes they should make to achieve a healthier weight.
Drugs therapy suggested by your physician
The therapy suggested by the physician may include
- Orlistat – Inhibits the secretion of pancreatic/intestinal lipase.
- Sibutramine – It stimulates fasting and postprandial thermogenesis.
Surgical interventions are occasionally used to treat morbidly obese patients when other treatments have failed.
But, you cannot do this alone. In matters of HEART, always seek expert help. If you are lucky to have a VLCC center near your home, do visit them. They are having an up to 50% off on health care packages. Check out this link: VLCC Get Well Soon for details!