Obesity is a chronic disease that places increased strain on the cardiovascular system....
Obesity is a chronic disease that places increased strain on the cardiovascular system. Adipose tissue is not merely an energy reserve — it is an active endocrine organ that produces hormones and biologically active substances affecting the entire body. Kamila Kahramonzhonovna Kholmatova, MD, PhD, Associate Professor at the Department of Hospital Therapy and Endocrinology of NArFU (Northern State Medical University), explains how obesity affects the cardiovascular system. 🔹 Increased workload: the greater the tissue volume, the more blood the heart has to pump. This leads to left ventricular hypertrophy and cardiomegaly — and, consequently, to a higher risk of heart failure, myocardial infarction and sudden cardiac death. 🔹 Insulin resistance and type 2 diabetes: obesity is a key driver of insulin resistance, which leads to diabetes. Elevated glucose and insulin levels damage the blood vessels and the heart, accelerating the development of coronary heart disease. 🔹 Arterial hypertension: obesity is often accompanied by high blood pressure. Several mechanisms are at play here: sodium retention caused by insulin resistance, chronic inflammation, and hyperactivation of the renin–angiotensin–aldosterone system. Elevated blood pressure puts additional strain on the heart and damages the blood vessels. 🔹 Impaired lipid metabolism: in obesity, the level of atherogenic lipid fractions rises, accelerating the development of atherosclerosis — including in the coronary arteries — and increasing the risk of angina and heart attack. 🔹 "Obesity of the heart": fat accumulates both around the heart and between its muscle fibers, compressing the organ and disrupting metabolism in the myocardium. 🔹 Chronic inflammation: adipose tissue produces cytokines that trigger inflammation and fibrosis, damage the vascular endothelium and aggravate atherosclerosis. The combination of obesity, hypertension, dyslipidemia and impaired carbohydrate metabolism forms metabolic syndrome, which multiplies the risk of cardiovascular events. ❓ Which type of obesity is more dangerous? 🔹 Visceral (abdominal) obesity — when fat accumulates around the internal organs in the abdominal area. This type of tissue is more likely to promote insulin resistance and inflammation. An increased waist circumference should raise concern even if the body mass index is normal (healthy values: up to 80 cm for women and up to 94 cm for men). According to the "Know Your Heart" study, for residents of Arkhangelsk the waist-to-height ratio is even more important (normally below 0.5) — in other words, your waist should be at least half your height. ❓ What can be done? Many of these changes are reversible with weight loss. Losing even 5–10% of body weight improves insulin sensitivity and lipid profile readings and lowers blood pressure. A healthy diet, proper hydration, regular physical activity (3–5 hours a week) and 7–8 hours of sleep all help, with medication prescribed when necessary. If you are overweight, seek help from a general practitioner or an endocrinologist. ✅ This publication is timed to coincide with Responsible Heart Care Week.