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Want a Healthy Heart? Maintain a Healthy Weight

Feb 10, 2015
by Myers Hurt, MD

photodune-4017465-tape-measure-heart-shape-health-weight-concept-xsDiabetes is often the most feared health complication of obese adults, and the rapid increase in the rate of the diagnosis strongly correlates to the current obesity epidemic. Diabetes is, however, only one of the many serious health complications of excess weight.

Most notably, obesity places a great deal of stress on the heart and can lead to multiple forms of heart disease. As weight increases, new blood vessels form to supply the additional fat tissue with oxygen and nutrients. As you can imagine, this increased workload directly causes an increase in blood pressure.

In addition, fatty deposits called plaques build up on blood vessels throughout the body, forcing them to become narrower. This process, known as atherosclerosis, also increases the amount of stress on the heart, causing even more of an increase in blood pressure. The combination of atherosclerosis and elevated blood pressure can be deadly and, in fact, is the duo responsible for heart attacks and strokes.

If high blood pressure (also known as hypertension) remains uncontrolled, it can lead to an overgrowth of the heart muscle, sometimes to the point of cutting off the heart's own blood supply. When ignored even longer, this can then lead to heart failure—a condition in which the heart muscle becomes too weak to pump blood to the rest of the body.

Obstructive sleep apnea is a condition that causes people to stop breathing intermittently throughout the night, and is extremely common in obese patients. Excess fat around the neck compresses the airway, and can also lead to elevated blood pressure—setting off the cascade discussed above. Heart failure is common in patients with obstructive sleep apnea as well, as excess pressure in the blood vessels leading to the lungs causes the heart to dilate and eventually fail.

According to recent statistics from the World Heart Federation, almost 20 percent of myocardial infarction (heart attacks) can be attributed to a body mass index (BMI) above 21 (still classified as a "normal" weight per most standards). In fact, other studies from the American Heart Association show that minimal increases in BMI—even those that remain in a "normal" range—correlate with notable increases in coronary artery disease.

The good news is that while small increases in weight have been shown to be exponentially detrimental to the heart, the opposite is also true. Weight loss, even in small amounts, significantly reduces your risk of developing heart disease. The weight loss plan proposed by the American Heart Association involves eating fewer calories than your body needs, getting aerobic exercise for 30 minutes five days a week, and learning the skills to change unhealthy behaviors. When a BMI is over 40, however, especially with multiple co-morbidities, bariatric surgery is the recommended treatment of choice. 

Remember to keep these so-called "silent killers" in mind when approaching your weight loss goals. Hypertension, heart attacks, and heart failure are all more common in obese populations—weight loss can truly be heart-healthy. 

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