P4791Different obesity paradox of ischemic stroke without and with atrial fibrillation
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Obesity is an independent predictor of cardiovascular diseases (CVD), including heart failure (HF). Nevertheless, numerous studies have shown that patients with CVD who are overweight and slightly obese have a better short-term and moderate prognosis than thinner patients with CVD. This phenomenon has been called the obesity paradox. Understanding the obesity paradox is important in patients with HF, given the high prevalence of obesity in patients with HF. The article presents an overview of clinical studies devoted to the study of obesity as a risk factor for HF, the pathogenesis of HF in obesity, and highlights the issues of the obesity paradox and the treatment of obesity in this category of patients.
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“Obes paradox” refers to the conclusion that obesity is contrary to the original obesity. Obesity may not reduce the survival time of patients, and the risk of death in some chronic diseases is inversely proportional to obesity. Obesity can have some adverse effects on an individual's life and society, but obesity is not completely harmful. Compared with people of normal weight, obese people are more likely to actively receive treatment and try various healthy behaviors. The disadvantages of obesity are far greater than the benefits. The most reasonable way is to maintain the health of various body types. Its basic concept is that healthy behaviors, including nutrition and physical activity, are more important than weight. At present, there are some studies on “obesity paradox” and research against the theory. Experts and scholars have their own opinions, but no study can accurately define whether the “obesity paradox” is established.
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In general population, cardiovascular (CV) mortality increases in parallel with obesity severity, determined by body mass index (BMI). However in cohorts of patients with coronary diseases or heart failure a decrease of the global mortality has been observed in patients aged more than 65 years old with moderate obesity (BMI = 30-35) compared to normal weight people (BMI = 20-25) and morbid obese (BMI > 35). This "obesity paradox" could result from the selection of obese people with healthy metabolic profile and way of life. BMI does not allow to distinguish lean body mass from fat mass and therefore to evaluate abdominal obesity which is associated with metabolic syndrome and CV risk.
Abdominal obesity
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The percentage of the population who are obese has grown dramatically on a worldwide basis over the last several decades, although the growth in the prevalence of obesity has slowed recently at a high level in the United States. Although there have been numerous studies of the effect of this trend on mortality, the findings have been inconsistent and controversial, in part because of methodological differences and the complexity of the relationships between obesity and mortality. The objective of this article is to discuss the issues surrounding these relationships and to shed light on the likely effects of the obesity epidemic on mortality. Of particular interest is the so-called obesity-mortality paradox, where mortality experience is lower for overweight and in some cases obese individuals than for those of normal weight. Although more recent studies of the relationship between mortality and obesity seem to indicate those who are obese have experienced a reduced percentage of additional mortality, this may in part be due to the shorter average time those currently obese have been exposed to their condition, the heterogeneity of the normal and obese populations, measurement issues including treatment of smokers and those who are ill, and study design limitations. An increased number of premature deaths may arise as more individuals who are obese are exposed for a longer period to excess adiposity. Although public policy issues surrounding obesity are being addressed with a great deal of activity and publicity, they have and will continue to prove quite challenging for both individuals and society to manage and overcome. The prevalence of obesity has had and will continue to have a significant effect on the mortality experience in most areas of actuarial practice. As a result, it is important for actuaries to enhance their understanding of these effects.
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Cardiovascular Health
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Obesity is an independent risk factor of cardiovascular disease(CVD).Obesity is closely related with hypertension,elevated levels of blood lipid and diabetes,and is responsible for the increment of heart disease occurrence rate.But the mortality rate in obesity patients with heart disease is lower than that in the patients whose weight is normal or lower.This kind of phenomenon is called as obesity paradox.Further researches on mechanisms of obesity paradox will bring a kind of new way for the treatment of CVD.
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