The effectiveness of the treatment of obesity in coronary heart disease

Prevalence of obesity. In the United States, over the past 40 years, the proportion of the population with excess MT (BMI> 25 kg / m2) and obesity (BMI> 30 kg / m2) has steadily increased. According to the 1960-1962 NHANES data, 31.6% of men and women had excess MT (BMI of 25.0-29.9 kg / m2), of which 13.4% were obese.

Today, almost 2 out of 3 Americans are overweight (MT) or obese; according to the NHANES 1999-2000, 64.5% of men and women had excess MT, 30.5% of which were obese.

The prevalence of overweight (MT) and obesity among children and adolescents is increasing in parallel with those in adults. At the age of 6-19 years, 15%, and at the age of 2-5 years, 10.4% were overweight (MT) or obesity. This is an alarming trend, because early obesity is a strong predictor of cardiovascular disease (CVD) in adulthood. It is particularly alarming that excess MT can lead to a dramatic increase in the incidence of DM-2 among children. In some areas of the United States,> 30% of new cases of DM-2 were observed among children, with most cases due to obesity.

Obesity risk. Obesity and overweight (MT) are strongly associated with the risk of coronary heart disease (CHD) and cerebral stroke (MI). Since different criteria were used to determine excess MT and obesity, the information and magnitude of this association with coronary heart disease (CHD) do not fully match. The question of whether overweight (MT) is an independent FD KBS, remains a matter of debate, because impact on the risk of coronary heart disease (CHD) may be mediated by arterial hypertension (AH), dyslipidemia (DLP), impaired glucose tolerance (NTG), inflammatory and hemostatic factors.

However, given the strong association with coronary heart disease (CHD), obesity remains an important and easily measurable risk marker.

Data from a number of cohort and metabolic studies provide similar evidence for a link between excess MT, NFA and impaired health. In a recent, long-term study, women studied obesity and NFA as predictors of CHD risk. Although BMI, the ratio of waist to hip volume, NFA independently contributed to the development of CHD, a study that lasted> 20 years showed that obesity increased the risk more than NFA.

Overweight (MT) increases the risk of metabolic disorders such as AH, DLP, IL and NTG. For example, in the Marks and Spenser Cardiovascular Risk Factor Study 14 077 middle-aged women, there were highly reliable, age-adjusted differences between 7 categories of BMI (from <20 to> 30 kg / m2) for GARDEN and DAD, total cholesterol, serum LDL, cholesterol HDL, TG, apo AI, apo B and fasting glucose levels. Excessive MT is associated in adults and children with increased markers of inflammation, such as CRP and fibrinogen, which are associated with an increased risk of CVD. There is a strong relationship between excess MT and an increased risk of CHD, ischemic MI, DMD-2, and other chronic diseases.

Overweight (MT) is an aggravating individual and economic factor. Estimates for 6 large prospective cohorts indicate that in the US, 280–320 thousand deaths per year are associated with overweight (MT), of which 80% occur in individuals with a BMI> 30 kg / m2. According to a national study of 10 thousand adult Americans, obesity is associated with a large number of chronic disorders and a worse quality of life than smoking or alcohol abuse.

Medical expenses for overweight conditions in 1998 were estimated at $ 78 billion (9% of total medical expenses in the United States). This amount is comparable to the cost of treating diseases associated with smoking. A study that examined the effect of increasing MT among men and women aged 35–65 years with initially excessive MT showed that the 3-year increase in health care costs was $ 561 more in individuals with an increase in MT by> 9 kg over this period compared with individuals whose MT remained stable.

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