waist circumference is the most practical marker for abdominal obesity
overweight and abdominal obesity are associated with other cardiovascular risk factors including small and dense atherogenic LDL cholesterol, low HDL cholesterol, raised triglycerides, elevated blood pressure, insulin resistance, and impaired glucose regulation including diabetes
weight reduction results in a lower blood pressure, lower LDL cholesterol and triglycerides, higher HDL cholesterol, and an improvement in hyperinsulinaemia and hyperglycaemia (1)
obese women have four times the risk of CHD than non-obese women (2)
in men being obese (BMI >30) or overweight is strongly associated with an increase in the risk of atherosclerotic disease (3)
a cohort study revealed that the adverse effects of overweight on blood pressure and cholesterol levels could account for about 45% of the increased risk of CHD (4)
NICE state that severe obesity (body mass index greater than 40 kg/m2) affects CVD risk and should be considered when using risk scores to inform treatment decisions (5)
Reference:
(1) JBS2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice. Heart 2005; 91 (Supp 5).
(2) Drug and Therapeutics Bulletin 1996; 34 (4): 28-30.
(3) Shaper AG et al. Body weight: implications for the prevention of coronary heart disease, stroke and diabetes mellitus in a cohort study of middle aged men. BMJ, 1997;314: 1311-7.
(5) NICE (May 2008).Lipid modification - Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease
(6) Drug and Therapeutics Bulletin 1998; 36: 89-92
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