The Powerful Connection Between Obesity and Cardiovascular Disease

January 6, 2010

Obesity is reaching epidemic levels in the United States and there are plenty of studies that show it greatly increases cardiovascular risk. But just how does it affect a person’s heart and arteries? Syed Raza, MD, is a board certified interventional cardiologist at Floyd Memorial’s Heart & Vascular Center. Here, he helps explain several ways in which obesity impacts cardiovascular health.

Obesity Leads to Blockage in the Arteries

“Insulin is a hormone that helps the body metabolize blood sugar, or glucose,” explained Dr. Raza. “Obesity increases insulin resistance, which makes the body less effective at digesting glucose. This leads to high blood sugar, which creates an environment that encourages the development of pre-diabetes or diabetes, a serious risk factor for heart disease. Also, because the insulin no longer works as well in the liver, the level of certain fats called triglycerides, increases in the blood. Bad cholesterol, or LDL, goes up, and good cholesterol, or HDL, goes down.”

estes“Being seriously overweight makes so many medical conditions more difficult for patients. For example, in my work, I’ve seen first hand how much harder recovery is for heart bypass patients who are obese. They suffer a much higher rate of complications. Wounds take longer to heal, and weaning them from a ventilator can be more challenging because it is hard for them to take deep breaths. Being in better physical shape not only helps prevent many serious medical conditions, but it also helps you bounce back faster when you do have a problem.”

Marla Estes, ARNP
Cardiovascular Nurse Practitioner
Floyd Memorial Heart & Vascular Center

Cholesterol is a chemical that is vital to a number of functions in the body. But an excessive level of cholesterol in the body can be harmful. As Dr. Raza explained, “LDL carries cholesterol from the liver and intestines to wherever it is needed in the body. But, when there is an excess, it starts to build up in the walls of arteries throughout the body, including those in the heart and brain. HDL takes cholesterol from the walls of the arteries and carries it back to the liver and intestines where it can be excreted.” When there is too little HDL to carry away the excess LDL, it leads to atherosclerosis, which is hardening and narrowing of the arteries. This is a major risk factor for heart attack and stroke.”

Excess Fat Creates an Inflammatory State

“We are also beginning to understand another way that obesity contributes to cardiovascular disease,” said Dr. Raza. “Fat tissue releases substances which create an
inflammatory state in the body,” said Dr. Raza. “This actually makes artery walls more prone to cholesterol build-up.”

Obesity Stresses the Heart in Other Ways

Obesity alone is damaging to the heart. According to Dr. Raza, “Even when there is no other risk factor such as diabetes or high blood pressure, being very overweight can lead to the cardiomyopathy of obesity. It is a weakening of the heart over time that is brought on by the extra workload it must handle. Obesity is also related to an increased occurrence of obstructive sleep apnea, which is a risk factor for the aggravation of congestive heart failure and arrhythmias, or irregular heart rates, which also stress the heart and can be fatal.”

raza“If there’s one thing I want to stress, it is the importance of exercise. When I talk with my overweight patients, I emphasize its tremendous value, and I encourage them not to attach the goal of weight loss to exercise when they start. Yes, they need to lose weight, but even before they do, they need to know they are improving their health simply by exercising. I tell them, ‘Just go out and walk briskly. Build up to 20 or 30 minutes of aerobic exercise every other day. And don’t get discouraged. You are making a positive difference already.’”
Syed Raza, MD
Board Certified Interventional Cardiologist
Kentuckiana Heart Doctors

Exercise has tremendous value and importance in improving the overall health of overweight patients.

A Healthy Recommendation “After the age of 30, everyone should be screened for lipid, or fat, levels in their blood,” said Dr. Raza. “During their regular physicals, blood levels of triglycerides and total cholesterol, as well as individual LDL and HDL cholesterol levels, should be tested.”

Dietary Tips for Lowering Cholesterol and Triglyceride Levels

  • Increase the amount of fruits and vegetables in your diet
  • Switch to nonfat or low-fat dairy products
  • Cut back on red meats
  • Eat fish that is high in omega-3 fatty acids, such as salmon and tuna, a couple of times a week
  • Cut out deep-fried foods (Yes, even fried fish)
  • Reduce alcohol consumption
  • Reduce saturated fat, trans fat and cholesterol According to Dr. Raza, “Diet modification is often enough to bring about a five to ten percent drop in cholesterol. If it remains high, medication may be required. Even then, modifying your diet is still an essential step.”