La medicina cardiometabolica nell’obesità

The rising prevalence of obesity worldwide has become a significant health issue, particularly as a key risk factor for cardiovascular disease (CVD). Obesity is linked to various cardiac complications, such as coronary artery disease, heart failure, and an increased risk of sudden cardiac events. It also contributes to other cardiovascular risk factors like dyslipidemia, type 2 diabetes, hypertension, and sleep disorders, heightening the risk of CVD. Understanding the pathophysiology connecting obesity and CVD is essential for effective treatment in obese patients. This includes considering adipose tissue dysfunction, chronic inflammation, immune dysregulation, and changes in the gut microbiome. Recent European Society of Cardiology (ESC) guidelines highlight the critical need to diagnose and treat obesity to prevent CVD. The complex interplay between obesity and CVD presents challenges in clinical practice: obesity can hinder precise CVD diagnosis and necessitates careful tailoring of pharmacological treatments and cardiac procedures. It’s imperative for diabetologists to consider the impact of excess weight in improving cardiometabolic outcomes for those with obesity. This article aims to clarify controversial aspects of managing heart disease in patients with overweight or obesity and reviews evidence on cardiometabolic outcomes from current weight management interventions.