Types of obesity and their impact on long-term outcomes in patients with cardiovascular disease

Large prospective studies involving several hundred thousands to several million people from the general population have shown that people with obesity have a higher overall mortality rate than people with a normal BMI. The use of BMI in predicting the prognosis of people with cardiovascular disease has led to the inverse relationship between BMI and risk of death. Obesity, determined by BMI, is very heterogeneous in determining prognosis in different groups of patients. The use of imaging techniques during the examination revealed that poor health effects are associated with the accumulation of visceral adipose tissue. New evidence also suggests that ectopic deposition of fat (in the liver, in the epicardium) may increase the risk of developing atherosclerosis and cardiovascular disease and type 2 diabetes. The number of studies examining the direct effect of visceral adipose tissue on mortality is very limited. Their results are extremely contradictory, based not on prospective observations, but on the construction of statistical models. Adipose tissue is currently considered as an endocrine and paracrine organ. Deposition of adipose tissue in the internal organs, in addition to metabolic disorders), probably leads to the formation of local adverse effects. The above data lead us to the conclusion that it is necessary to create a new classification that would improve the stratification of the risk of developing cardiovascular disease and death in people with obesity.