Obesity and Heart Disease: What’s the Connection?
It’s a known fact that obesity can take a toll on your heart health. And there’s a plethora of research to back it up. For instance, a recent study published in April 2018 in the journal JAMA Cardiology concluded that adults between ages 40 and 59 who are overweight or obese have a significantly increased risk (ranging from 21 to 85 percent higher) of developing cardiovascular disease as compared with their normal weight peers. Individuals who are overweight, defined as having a body mass index (BMI) between 25 and 29.9, or are obese (a BMI of 30 or higher), also have a much greater risk of developing cardiovascular disease at a younger age. The research showed that individuals who are obese had a shorter lifespan.
The link between heart disease and obesity is multifaceted. For one thing, obesity increases your risk of developing many other risk factors for heart disease. It also triggers inflammatory processes that can harm your cardiovascular system, and it can lead to structural or functional changes in the heart itself. Read on for the details.
Obesity’s Harmful Ripple Effects on the Heart
Obesity Increases Your Risk of Developing Other Heart Disease Risk Factors
These include hypertension, cholesterol abnormalities, and type 2 diabetes, all of which increase your chances of developing cardiovascular disease, notes Nieca Goldberg, MD, a cardiologist and medical director of the Joan H. Tisch Center for Women’s Health at the NYU Langone Medical Center in New York City. Being overweight also increases your risk of metabolic syndrome, a cluster of heart-disease risk factors, including high blood pressure, low levels of HDL (“good”) cholesterol, high triglyceride levels, high blood sugar levels, and a large waist circumference (35 inches or more for women, 40 inches or more for men).
Making matters worse, high blood pressure that’s brought on by obesity irritates plaque in the arteries and predisposes it to rupturing, which is what triggers a heart attack, adds Tracy Stevens, MD, a cardiologist at Saint Luke’s Mid America Heart Institute in Kansas City, Missouri.
Being Overweight Increases Your Chances of Developing Sleep Apnea
Obstructive sleep apnea is unpleasant enough by itself, given that it makes for a fragmented night’s sleep. But it’s also a risk factor for developing high blood pressure, type 2 diabetes, and heart disease. In fact, a study published in February 2018 in the journal Metabolic Syndrome and Related Disorders found that overweight people with mild sleep apnea were more likely to have metabolic syndrome, hypertension, prediabetes, and cholesterol abnormalities (especially high triglycerides).
Obesity Is Associated With Hidden Inflammation
This sneaky inflammation and the inflammatory factors it releases increase your risk of developing atherosclerosis and the buildup of plaque in the walls of the arteries. “Obesity also releases substances in the blood that can make plaque rupture, which is what leads to heart attacks,” Dr. Stevens explains. “Obesity is like broken glass to our arteries.”
Obesity Can Compromise Your Heart’s Ability to Function
Research shows that obesity can raise your risk of developing atrial fibrillation, a rapid irregular heartbeat (arrhythmia) of the upper chambers (atria) of the heart that can promote the formation of blood clots and lead to stroke, heart failure, or other heart-related complications, according to the American Heart Association. In addition, obesity can lead to enlargement of the heart, which could be from untreated hypertension, Dr. Goldberg says.
Those Extra Pounds Force Your Heart to Work Harder
Yes, the extra weight you’re carrying does put the heart under increased stress, in particular during the relaxation phase of the cardiac cycle — what’s called the diastole. As the heart fills with blood, there’s higher pressure, Goldberg explains. “Over time, that can cause people to have heart failure symptoms.”
It’s not just the number on the scale that matters. Where the extra weight is distributed also affects your risk of developing heart disease. Simply put, greater amounts of belly fat — what’s often called central or abdominal obesity — is associated with greater inflammation, which is damaging to your heart, Goldberg says. Excess belly fat also increases triglyceride levels, which can contribute to plaque rupturing, Stevens notes. That’s why your waist measurement really does matter, in addition to your overall weight
Taking Action to Protect Your Heart
The news isn’t entirely bad, though. If you’re overweight or obese, slimming down can help you reduce your risk of developing heart disease. “When people lose as little as 5 pounds (lbs), we can start to see improvements in blood pressure, blood sugar, cholesterol levels, and inflammatory factors,” Goldberg says. All of these changes are beneficial for your heart.
Indeed, losing excess weight helps with primary prevention of heart disease, as well as secondary prevention (preventing another heart attack or other cardiac event if you’ve already had one), Goldberg says. For secondary prevention, she adds, “you’ll need to take medicine, but maybe less of it if you lose weight.”
It’s not an easy process, Goldberg admits, but the best ways to lose weight are to improve your diet and exercise habits with the goal of losing 1 lb per week. Keep in mind: “If your BMI is in the higher range, it’s safer to go into a medically supervised weight loss program than to try to do it on your own,” Goldberg says.
If you’re doing it on your own, stick with a diet that’s filled with fruits and vegetables, whole grains, low-fat dairy products, fatty fish and skinless poultry, nuts and legumes, and healthy cooking oils, such as olive, walnut, sesame, or grapeseed oils. Avoid added sugars, highly processed foods, and fried foods. On the exercise front, do a combination of “aerobic exercise and weight training to increase your muscle mass and decrease body fat,” Goldberg suggests.
There’s proof that taking these steps can make a difference to your heart health. A study published in May 2016 in the journal Preventive Medicine found that adults ages 18 to 35 with BMI between 25 and 40 who participated in a weight-loss program lost an average of 17.5 lbs, increased their levels of physical activity, and improved their total cholesterol, blood pressure, and blood sugar levels after six months. “Losing weight will reduce the risk of cardiovascular disease significantly — because it makes a difference in blood pressure, insulin sensitivity, and triglyceride levels,” Stevens says. “The great news is, what you do every day can make a difference.”