Cardiovascular disease (CVD) is the foremost cause of mortality worldwide, taking an estimated 17.9 million lives each year.1 The development of CVD is influenced by various risk factors that often coexist and contribute synergistically to the progression of cardiovascular disease.2 These may include hypertension (high blood pressure), hyperlipidemia (elevated cholesterol levels), and diabetes mellitus.3,4
Hypertension strains the heart by increasing the pressure against which it must pump blood, leading to arterial damage. Hyperlipidemia, characterised by high levels of low-density lipoprotein (LDL) cholesterol and triglycerides, results in plaque buildup in the arteries, narrowing them and restricting blood flow. This can lead to atherosclerosis, resulting in adverse cardiac events. Diabetes, with its chronic high blood glucose levels, accelerates the process of arterial damage and increases the likelihood of heart disease.5
These risk factors do not act in isolation. Their combined presence compounds their individual effects, presenting a cascade of adverse health outcomes and creating a more complex and challenging health scenario.4
Dr. Tiny Nair, MD, DM, FACC, FRCP, Head, Dept of cardiology,, PRS Hospital, Trivandrum 695002, Kerala, IN
Link between weight and cardiometabolic risk factors
The relationship between weight and cardiometabolic risk factors is bidirectional; while excess weight exacerbates these conditions, the presence of these risk factors can further contribute to weight gain.6Obesity can cause insulin resistance, making it harder for the body to control blood sugar and increasing the risk of Type 2 diabetes. The fat tissue releases fatty acids, raises inflammation markers, and lowers levels of a protein that helps improve insulin sensitivity. Extra fat, especially around the belly, also leads to higher blood pressure and unhealthy cholesterol levels, which are key parts of metabolic syndrome.6,7
Addressing the combined risks and moving forward
Managing the combined effects of cardiometabolic risk factors requires a comprehensive approach. This involves modifying underlying risk factors and addressing each parameter individually while also considering their interactions.8 Effective management typically includes lifestyle modifications such as adopting a balanced diet, engaging in regular physical activity, and, where appropriate, using medications to control blood pressure, cholesterol levels, and blood glucose.6
Losing weight can help lower inflammation and improve health, whether it’s through diet, exercise, medication, or surgery. Maintaining a healthy weight can reduce insulin resistance, lower blood pressure, and improve cholesterol levels, which lowers the risk of heart disease. Since managing these factors can be challenging, it’s important to get personalised advice from healthcare professionals.
Conclusion
The combined effect of cardiometabolic risk factors on heart health underscores the importance of a comprehensive management approach. By addressing individual conditions and their interactions, particularly through weight management, patients can mitigate the risks and improve their cardiovascular health. Regular medical consultation is key to navigating the complexities of cardiometabolic health and achieving optimal outcomes.
References:
- World Health Organization. Cardiovascular diseases. Available from: Link
- Bakhtiyari, M., et al. Sci Rep 12, 1544 (2022).
- Mayo Clinic. Metabolic syndrome: Symptoms and causes. Available from: Link on 22 aug 2024.
- Johns Hopkins Medicine. Metabolic syndrome. Available from: Link. on 22 aug 2024.
- American Heart Association. About metabolic syndrome. Available from: Link on 22 aug 2024.
- Repas, T, et al. The Journal of the American Osteopathic Association. 107. S4-11. 10.7556/jaoa.2007.20009.
- Piché ME, et al. Circulation Research. 2020;126(11):1477-1500.
- Rama Hritani,et al. Obesity Pillars, Volume 7, 2023, 100069.
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