Obesity and Prevalence of Cardiovascular Diseases and Prognosis-The Obesity Paradox Updated

Prog Cardiovasc Dis. 2016 Mar-Apr;58(5):537-47. doi: 10.1016/j.pcad.2016.01.008. Epub 2016 Jan 28.


The prevalence and severity of obesity have increased in the United States and most of the Westernized World over recent decades, reaching worldwide epidemics. Since obesity worsens most of the cardiovascular disease (CVD) risk factors, not surprisingly, most CVDs, including hypertension, coronary heart disease, heart failure, and atrial fibrillation, are all increased in the setting of obesity. However, many studies and meta-analyses have demonstrated an obesity paradox with regards to prognosis in CVD patients, with often the overweight and mildly obese having a better prognosis than do their leaner counterparts with the same CVD. The implication for fitness to markedly alter the relationship between adiposity and prognosis and the potential impact of weight loss, in light of the obesity paradox, are all reviewed.

Keywords: Cardiorespiratory fitness; Cardiovascular diseases; Obesity; Weight loss.

Publication types

  • Review

MeSH terms

  • Adiposity
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control
  • Epidemics*
  • Health Status
  • Hemodynamics
  • Humans
  • Obesity / diagnosis
  • Obesity / epidemiology*
  • Obesity / physiopathology
  • Obesity / therapy
  • Obesity, Metabolically Benign / epidemiology
  • Obesity, Metabolically Benign / physiopathology
  • Physical Fitness*
  • Prevalence
  • Prognosis
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Weight Loss