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Obesity and the Heart
How is obesity related to heart disease?
Obesity is commonly defined as a percentage over ideal body weight. For example, mild obesity is defined as body weight 20% to 40% more than your ideal body weight, moderate obesity as weight 40% to 100% more than ideal, and severe obesity as weight more than 100% of ideal. The range of ideal body weight varies with your height, frame size, and gender. By consulting standard tables, your doctor can give you a good sense of whether or not your weight puts you in the category of being obese. Obesity is associated with a number of health problems including hypertension, diabetes, pulmonary hypertension and musculoskeletal difficulties. In addition to these other health problems, obesity can cause changes in the structure and function of the heart. This can happen even if you do not otherwise have heart disease.
What are the effects of obesity on the heart?
As body weight increases, the total volume of blood in the body also increases. The cause of the increased volume is unclear, but it forces an abnormally high output of blood from the heart even at rest. The increased blood volume and output make the heart work harder. The individual heart chambers stretch and expand. The added workload causes thickening of the heart muscle of the lower left chamber, the left ventricle. The thickening affects both contraction (squeezing) and relaxation of the heart. Over time, the heart may not be able to keep up with the load. Congestive heart failure with shortness of breath or fluid accumulation in the lungs may be the result.
Obese people frequently have high blood pressure. High blood pressure makes the heart work harder. This makes the heart muscle even thicker. Normal heart contraction and relaxation are affected, and the heart may no longer function normally.
Many obese people develop shortness of breath when they lie down to sleep because their large abdomens interfere with the function of their diaphragms. In addition, the weight of the fat over the chest wall may affect the normal bellows function of the rib cage. Some very obese people develop obstruction of the airway to the lungs when they sleep. The effect of gravity on the relaxed, thickened tissues and muscles of the throat and neck block the passage of air to the lungs. This causes them to temporarily stop breathing, a condition called apnea. These periods of apnea reduce the amount of oxygen in the blood. The low oxygen due to apnea can affect the heart's rhythm and may be responsible for some cases of death during sleep. The low blood oxygen also causes an increase in blood pressure in the lungs. The persistent increase in lung blood pressure eventually puts a strain on the right ventricle of the heart. The right ventricle, which pumps blood through the lungs, is unable to keep up. Symptoms of breathlessness or body tissue fluid accumulation often result.
Does obesity cause coronary heart disease and heart attacks?
Because obesity is associated with a number of metabolic abnormalities including diabetes and elevated blood lipids, there is an increased risk of hardening of the arteries in patients with obesity. This increases the risk of heart attacks and sudden death.
If I lose weight, can these changes be reversed?
This depends in part on the severity of the changes that have occurred. Before significant damage has occurred, weight reduction and a gradual reconditioning program may completely restore health. Blood pressure should be treated vigorously as should abnormal blood lipids. Ask your doctor or nutritionist about prudent diet programs that are likely to result in long term success.
What are the effects of obesity on the heart?
As body weight increases, the total volume of blood in the body also increases. The cause of the increased volume is unclear, but it forces an abnormally high output of blood from the heart even at rest. The increased blood volume and output make the heart work harder. The individual heart chambers stretch and expand. The added workload causes thickening of the heart muscle of the lower left chamber, the left ventricle. The thickening affects both contraction (squeezing) and relaxation of the heart. Over time, the heart may not be able to keep up with the load. Congestive heart failure with shortness of breath or fluid accumulation in the lungs may be the result.
Obese people frequently have high blood pressure. High blood pressure makes the heart work harder. This makes the heart muscle even thicker. Normal heart contraction and relaxation are affected, and the heart may no longer function normally.
Many obese people develop shortness of breath when they lie down to sleep because their large abdomens interfere with the function of their diaphragms. In addition, the weight of the fat over the chest wall may affect the normal bellows function of the rib cage. Some very obese people develop obstruction of the airway to the lungs when they sleep. The effect of gravity on the relaxed, thickened tissues and muscles of the throat and neck block the passage of air to the lungs. This causes them to temporarily stop breathing, a condition called apnea. These periods of apnea reduce the amount of oxygen in the blood. The low oxygen due to apnea can affect the heart's rhythm and may be responsible for some cases of death during sleep. The low blood oxygen also causes an increase in blood pressure in the lungs. The persistent increase in lung blood pressure eventually puts a strain on the right ventricle of the heart. The right ventricle, which pumps blood through the lungs, is unable to keep up. Symptoms of breathlessness or body tissue fluid accumulation often result.
Does obesity cause coronary heart disease and heart attacks?
Because obesity is associated with a number of metabolic abnormalities including diabetes and elevated blood lipids, there is an increased risk of hardening of the arteries in patients with obesity. This increases the risk of heart attacks and sudden death.
If I lose weight, can these changes be reversed?
This depends in part on the severity of the changes that have occurred. Before significant damage has occurred, weight reduction and a gradual reconditioning program may completely restore health. Blood pressure should be treated vigorously as should abnormal blood lipids. Ask your doctor or nutritionist about prudent diet programs that are likely to result in long term success.
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