Obesity and Cardiovascular Disease PDF

Preface

Over 65% of adults in the United States are overweight or obese with over 60 million Americans meeting the National Institutes of Health definition of frank obesity. These figures are even more startling when one realizes that the number of obese individuals has increased by 50% in the past decade. Although cardiovascular disease remains the number one proximate cause of death in the United States, it is now estimated that obesity or ‘‘overnutrition'' may be equivalent to smoking as the leading cause of preventable death in the United States. Not surprisingly, there is a significant association between obesity and cardiovascular disease. Thus obesity and cardiovascular disease are major public health concerns. These conditions afflict millions and cost billions of dollars to treat.

This text was developed out of a growing imperative for all clinicians to understand and address two of the major health problems of our time. Obesity and cardiovascular disease are frequently seen daily, and often concomitantly, in many clinical practices. The book is intended for students, medical generalists, and specialists alike who wish to gain understanding of the epidemiology of obesity and cardiovascular disease, while reviewing the current understanding of pathological changes that occur in the obese.

The book starts with an overview of the epidemiology of the obesity epidemic and its relationship to cardiovascular disease. Chapters 1 to 8 outline our current understanding of genetics and the pathophysiological changes in the obese that lead to the development of heart disease and vascular dysfunction. Obesity-related syndromes are reviewed as well. Chapters 9 to 17 present expected improvement in cardiovascular risk factors with weight reduction in the obese, and address specific treatment strategies for managing the obese patient with cardiovascular disease. Whenever possible, the authors have included recommendations on medical management issues that may be of specific relevance to the obese patient. Finally, given the huge public health implications of overnutrition; the concluding chapter discusses public health initiatives and obesity prevention strategies.

All too often patients are treated for cardiovascular disease without concerted effort to address significant weight issues. This book provides the rationale as well as approach to management of a complex and common group of patients, emphasizing the need to treat both cardiovascular disease and obesity. The effect of such a combined treatment strategy may be synergistic. We believe this text will be a valuable tool for anyone who provides care for obese patients with cardiovascular disease.

A new book does not succeed without the hard work of many individuals. We would like to thank all the authors who have contributed their time and effort to make this new text a valuable resource. In addition, there are a few individuals who are essential to the successful completion of such a project, but work behind the scenes. We would like to thank specifically two individuals— Barbara Hodges and Kris Mogensen—who are also co-authors of this book. With their administrative and editorial assistance, Barbara and Kris have helped bring this book from its inception to its finish and have made the journey much easier than it would have been without their help.