9/25/2014. قلب و عروق. 1. Central obesity By : Dr. H – Aghajani Interventional cardiologist NCDC Director Ministry of Health and Education. Approximately 2/3 billion adult : overweight More than 700 million adult : obese. WHO predict by 2015:.
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قلب و عروق
Dr. H – Aghajani
Ministry of Health and Education
More than 700 million adult : obese
An estimated 300 million people around the world are obese as defined by a body mass index (BMI) of 30 or more
At least 155 million school-age children worldwide are overweight or obese
In the world as defined by a body mass index (BMI) of 30 or more:
IHD is responsible for all deaths in 2004 and is as defined by a body mass index (BMI) of 30 or moreestimated to be 14.2% in 2030
In the developing world the prevalence of the risk factors for CVD is increasing
17.5 million people died from as defined by a body mass index (BMI) of 30 or morecardiovascular disease in 2005, representing around 30 % of all global deaths
7.6 million deaths were due to heart attacks and 5.7 million were due to stroke
80% of these deaths occurred in low and middle income countries
CVD is 31% of all Death causes
Lancet 2007 ; 370:1929 -38 as defined by a body mass index (BMI) of 30 or more
In Iran as defined by a body mass index (BMI) of 30 or more:
Chronic NCDs are 79% of death causes and 85%of diseases burden
CVD is the first cause of death(46%) and IHD is the main causes
Macro physical, cultural, economic and social environment
Excessive as defined by a body mass index (BMI) of 30 or morefood intake
Arterial & venous
cardiac & cerebral events
Chronic heart failure
Life style is a Driver of CVD
Life style intervention
Risk factor modification
Major Unmet Clinical Need
Novel Risk Factors
Classical Risk Factors
Properties of key adipokines as defined by a body mass index (BMI) of 30 or more
IAA: intra-abdominal adiposity
Increased Cardiometabolic Risk
Adapted from Eckel et al 2005
is often associated with other CV risk factors
is an independent CV risk factor
Adipocytes are metabolically active endocrine organs, not simply inert fat storage
Increased Cardiometabolic Risk
Direct observations show that abdominal (visceral) obesity is more closely associated to NIDDM than CVD, while an increased WHR without obesity may be more closely linked to CVD than NIDDM.
For a 1 cm increase in WC, the relative risk (RR) of a CVD event increased by 2% (95% CI: 1-3%) overall after adjusting for age, cohort year, or treatment.
For a 0.01 U increase in WHR, the RR increased by 5% (95% CI: 4-7%). These results were consistent in men and women.Eur Heart J. 2007 Apr;28(7):850-6. Epub
Waist circumference was independently associated with increased age-adjusted risk of CHD, even after adjusting for BMI and other CV risk factors
p for trend = 0.007
<69.8 69.8-<74.2 74.2-<79.2 79.2-<86.3 86.3-<139.7
Quintiles of waist circumference (cm)
Rexrode et al 1998
The HOPE Study
Adjusted relative risk
Adjusted for BMI, age, smoking, sex, CVD disease, DM, HDL-C, total-C
Dagenais et al 2005
CV risk factors in a typical patient with abdominal obesity
Patients with abdominal obesity (high waist circumference) often present with one or more additional CV risk factors
Waist circumference (cm)
Carey et al 1997
US population age >20 years
Prevalence of high waistcircumferenceassociated with (%)
a<40 mg/dL (men) or <50 mg/dL (women); b>150 mg/dL; c>110 mg/dL; d>130/85 mmHg; eNCEP/ATP III metabolic syndrome
NHANES 1999–2000 cohort; data on file
% vascular risk factors
Obesity is associated with the following types of cancer:
endometrium (the lining of the uterus)
National Cancer Institute
In 2002, an estimated 41,000 new cases of cancer in the United States were due to obesity. About 3.2 percent of all new cancers are linked to obesity (1).
14% of deaths from cancer in men & 20% of deaths in women were due to overweight and obesity(2).
Obesity and Cancer
1. Polednak AP. Trends in incidence rates for obesity-associated cancers in the U.S. Cancer Detection and Prevention 2003; 27(6):415–421.
2. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. New England Journal of Medicine 2003; 348(17):1625–1638.
Obesity and physical inactivity may account for 25%-30% of cancer of the colon, breast (postmenopausal), endometrial, kidney, and esophagus
Preventing weight gain can reduce the risk of many cancers. Healthy eating and physical activity early in life can prevent overweight and obesity.Obesity and Cancer
National Cancer Institute
Our intervention will incorporate an intensive parental intervention within an established adolescent program (TEENS Program).
بر cancer of the colon, breast (postmenopausal), endometrial, kidney, and esophagus اساس یک مطالعه در آمریکا که در مردان و زنان چاق 64-35 سال انجام شد، تنها 10% کاهش پایدار BMI در افراد چاق، بسته به سن، جنس، و میزان BMI اولیه، با نتایج زیر همراه بود:
کاهش سال های زندگی توام با فشار خون بالا (2/9-1/2 سال)، دیابت نوع2 (1/7-0/5 سال) ، کلسترول خون بالا (0/8-0/3 سال)
کاهش میزان بروز سکته مغزی 13-1 مورد درهزار و بیماری عروق کرونر 38-12 مورد در هزار در طول زندگی.
افزایش امید به زندگی به میزان 7-2 ماه.
کاهش هزینه مراقبت های بهداشتی 5 بیماری مذکور در طول زندگی به میزان 5300-2200 دلار.
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