Jose Luis Palma-Gamiz

Vice-President of The Spanish Heart Foundation, Spain

Title: Obesity: The most prevalent cardiovascular risk factor. A matter of weight for the heart

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Biography

Medical Graduation:Navarra University. School of Medicine. Pamplona. Spain.

Post-Graduate Medical Training: University Hospital. Pamplona. Spain: Internal Medicine.

Training on Internal Medicine: University Hospitals. Montreal University (Canada)

Training on Cardiology and Hypertension: Research Institut. Montreal University (Canada).

Specialist in Cardiology. Complutensis Madrid University.Fellow. Cardiologist at the Department of Cardiology. La Paz University Hospital. Madrid (Spain). Head of Coronary Care Unit. “Ramón y Cajal” University Hospital. European Specialist on Hypertension

Assistant Professor of Cardiology. Alcalá de Henares University, School of Medicine. Other activities: Vice-President of the Spanish Heart Foundation.Member of The Scientific Committee of The Journal of Spanish Society of Cardiology. Former Director of  The American Journal of Hypertension (Spanish edition).

Member of several national and international Societies of Cardiology

Abstract

Institutions such as the World Health Organization (WHO) and the American Medical Association have recognized obesity as a complex, multifactorial, chronic disease with serious cardio-metabolic and tumor consequences. Nevertheless, there is a regrettable lack of awareness about this serious public health problem, although measures are already being taken to strictly address this authentic pandemic of our time.

The pathophysiological events that appear in obesity are complex and feed into each other. On the one hand, obesity induces insulin resistance, promotes the explosion of pro-inflammatory factors such as inflammatory adipocytokines, tumor necrosis factors, beta-transforming growth factors, etc. In addition, there is an increase in plasma concentrations of leptin (hunger hormone) and increase in prothrombotic agents (thromboglobulin, plasminogen activating factor PAI-1, platelet activating factor, etc). On the other hand, it induces a fatty infiltration in various tissues, including the myocardium, impoverishing its contractile function. All these phenomena are all the more relevant the higher the degree of obesity, facilitating the appearance of metabolic syndrome, type 2 diabetes, increased atherogenic lipids, which in turn negatively affects the heart causing coronary heart disease (angina and heart attack ) heart failure and arrhythmias. Regarding the coronary system, the lesions observed are very similar to those of type 2 diabetics. Medications such as orlistat, sibutramine, or rimonabant have been tried in various clinical studies with moderate success. When dietary resources and slimming medication have not achieved the desired goal and the BMI is close to or above 40%, bariatric surgery is recommended, the results of which are very acceptable and its complications are few.