THE OBESITY PARADOX
The term ''obesity paradox'' refers to the observations that, although obesity is a major risk factor in the development of cardiovascular and peripheral vascular disease, when acute cardiovascular decompensation occurs, for example, in myocardial infarction or congestive heart failure, obese patients may have a survival benefit. 1 In addition, it has been suggested that obese patients tend to fare better after certain surgical procedures, such as coronary artery bypass surgery. [2][3][4] Moreover, it appears that obese men with chronic hypertensive heart disease live longer than men of normal weight.
Major hypotheses for this apparent survival effect include:
- Obese patients may have better and more aggressive medical care and enhanced observation than normal-weight populations. 2. Obese patients tend to be on more, and perhaps better, cardioprotective medical therapy than other groups of patients. 3. Obese patients tend to be younger at the time of the acute cardiovascular event, which may confer an age benefit. 4. Some experts claim the sample size of the existing studies on obesity is still too small or too indecisive to make such determinations. 5 5. Other investigators suggest the way we measure obesity is unsatisfactory and may explain some of the paradoxic results seen. Specifically, using gross weight and the Conflict of interest: None.