Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8963253 | Progress in Cardiovascular Diseases | 2018 | 33 Pages |
Abstract
Recent advances in medical technology and health care have greatly improved the management for chronic diseases and prolonged human lifespan. Unfortunately, increased lifespan and the aging population impose a major challenge on the ever-rising prevalence of chronic diseases, in particular cardiometabolic stress associated with the pandemic obesity in our modern society. Although overweight and obesity are associated with incident cardiovascular diseases (CVD), including heart failure (HF), it paradoxically leads to a more favorable prognosis in patients with chronic HF, a phenomenon commonly defined as “obesity paradox”. Numerous population-based and clinical studies have suggested possible explanations such as better metabolic reserve, smoking and disease-associated weight loss for obesity paradox. Recent evidence noticed a shift in obesity paradox with aging. While some studies have reported a more pronounced “obesity paradox” in the older patients, others have seen diminished cardiac benefits with overweight and obesity in the elderly patients with CVD. These findings suggested that a complex relationship among aging, metabolism, and HF severity/chronicity, which may explain the shift in obesity paradox in the elderly. Aging negatively affects body metabolism and cardiac function although its precise impact on obesity paradox remains elusive. To develop new strategies for cardiovascular health in the elderly, it is imperative to understand the precise role for aging on obesity-related CVD.
Keywords
GWTG-HFHFpEFHFrEFNord-Trøndelag Health StudyT2DMSTEMINYHACRFCHDLVEFRAASeuroSCORECardiorespiratory fitnessMyocardial infarctionMetabolic stressNew York Heart AssociationST-segment elevation myocardial infarctionFatty acid oxidationSurvivalcoronary heart diseasecardiovascular diseasePercent body fatWaist circumferenceType 2 diabetes mellitusCVDAgingEuropean System for Cardiac Operative Risk EvaluationRenin-angiotensin-aldosterone systembody mass indexBMIHuntFAOAtrial fibrillationCardiaccardiovascularObesityHeart failure with preserved ejection fractionheart failureheart failure with reduced ejection fractionParadoxleft ventricular ejection fraction
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Authors
Shuyi Wang, Jun Ren,