The Impact of Obesity on Adverse Cardiovascular Outcomes in the General Population and in patients with Type 2 Diabetes

Objectives There is an established causal link between obesity and cardiovascular outcomes. The aim of this review was to determine whether an independent relationship exists between anthropometric measurements of weight (typically body mass index [BMI]) and cardiovascular outcomes (e.g. angina, myocardial infarction, congestive heart failure, stroke, and mortality due to cardiovascular disease) in the general population and in patients with type 2 diabetes. Methods A review of the medical literature published between 1988 and May 2008 was conducted using the PubMed, EMBASE, Cochrane and Center for Review and Dissemination databases. Studies longer than 12 months, with ≥500 adult subjects and published in English were included. Results In studies conducted in general populations there was an overall trend towards increased risk for adverse cardiovascular outcomes with increasing BMI. The nature and strength of this relationship varied according to the measurement used (e.g. BMI, waist circumference, waist-to-hip ratio) and the population studied, with notable differences observed in Asian/Asia-Pacific compared with European or North American-based studies. However, data from diabetes-specific populations are limited. Conclusions In general, the degree of being overweight or obese was associated with an elevated risk of adverse cardiovascular events and mortality. Although inextricable links exist between obesity, type 2 diabetes and cardiovascular disease in the general population, the extent to which findings can be extrapolated to a diabetes-specific population is limited