Overweight and its reduction from cardiovascular perspective
Pécsi Tudományegyetem, I. sz. Belgyógyászati Klinika, Endokrinológiai és Anyagcsere Tanszék, Pécs
The lowest point of the J-curve relationship between body weight and cardiovascular mortality falls in the normal weight range in case of the general population, however, paradoxically, it shifts toward obesity in certain high-risk patient groups. Data on the effect of conscious weight loss on mortality are also contradictory: some studies have shown a negative cardiovascular effect, while others have a positive one. However, all this did not substantially change the weight-loss paradigm of the mainstream recommendations. Lifestyle or pharmacological treatments for obesity have low efficacy and their beneficial cardiovascular effects at the level of clinical endpoints in randomized trials have so far not been convincingly demonstrated. The benefits and safety of glucagon-like peptide-1 receptor agonists in diabetic studies enhance confidence in the class of drugs, including in the treatment of obesity. There are no large randomized clinical trials with the more effective invasive bariatric/metabolic interventions.