Key result
Managing concurrent obesity and cardiovascular disease presents unique diagnostic and therapeutic challenges that require careful adjustment of pharmacological treatments and cardiac procedures.
Why the study?
Unique clinical challenges complicate the diagnosis and treatment of CVD in patients with overweight/obesity, and managing obesity alongside CVD involves diagnostic limitations, treatment adjustments, and confusion surrounding the obesity paradox.
This review outlines the unique clinical challenges in diagnosing and managing cardiovascular disease in patients with obesity, emphasizing the need for tailored pharmacological, procedural, and lifestyle interventions.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Excess fat acts as a kind of filter and can skew test readings to under- or overdiagnosis. Obesity affects nearly all the diagnostic tests used in cardiology, such as ECG, CT scan, MRI and echocardiogram.”
“As cardiologists, we see a number of challenges that our cardiac patients with obesity face as we try to treat their heart conditions, but also some challenges with cardiac conditions in patients with obesity when they try to lose weight. It works both ways. The presence of one makes the treatment of the other more difficult, and vice versa.”
“CVD and obesity are common conditions that frequently coexist. We cannot treat one of these conditions while ignoring the other.”
Caution advised applying standard CVD diagnostics/therapies to obese patients; leaves open obesity-specific prospective validation.
Many unique clinical challenges accompany the diagnosis and treatment of cardiovascular disease (CVD) in people living with overweight/obesity. Similarly, physicians encounter numerous complicating factors when managing obesity among people with CVD. Diagnostic accuracy in CVD medicine can be hampered by the presence of obesity, and pharmacological treatments or cardiac procedures require careful adjustment to optimize efficacy. The obesity paradox concept remains a source of confusion within the clinical community that may cause important risk factors to go unaddressed, and body mass index is a misleading measure that cannot account for body composition (eg, lean mass). Lifestyle modifications that support weight loss require long-term commitment, but cardiac rehabilitation programs represent a potential opportunity for structured interventions, and bariatric surgery may reduce CVD risk factors in obesity and CVD. This review examines the key issues and considerations for physicians involved in the management of concurrent obesity and CVD.
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Bianchettin et al. (2023) conducted a review in Cardiovascular disease and obesity. Management of concurrent obesity and cardiovascular disease was evaluated. Managing concurrent obesity and cardiovascular disease presents unique diagnostic and therapeutic challenges that require careful adjustment of pharmacological treatments and cardiac procedures.
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