Does obesity increase the risk of a heart attack?
In the United States, the rate of obesity among adults is 42 percent, according to the Centers for Disease Control and Prevention (CDC). Weight is only one factor when considering someone’s health, but researchers have found a correlation between obesity and heart issues. To make it worse, the issue with obesity isn’t affecting everyone equally: Rates are slightly higher among Black Americans.
How Obesity Might Affect the Body
It’s possible to have a high BMI (body mass index) while maintaining “normal” or healthy blood pressure, blood sugar, and so on. Still, higher BMIs are statistically correlated with a higher risk of these health issues. What's more, weight loss often leads to improvement.
Here’s one reason why: Obesity tends to involve visceral fat, which is a fat that builds up around the organs. People of any size can have visceral fat (it’s often called a “hidden fat” because even thin people can have it). This fat tissue can increase inflammation in the body. Over time, this can start to have negative effects on your organs and overall health.
Obesity and Heart Health
Obesity is a risk factor for heart disease because it can affect three key components of heart health: blood sugar, blood pressure, and cholesterol. Visceral fat increases the risk that these numbers will go up, increasing the risk of heart disease. Here’s how each affect the blood vessels in particular:
- High blood sugar is linked to a narrowing of the arteries, which makes the heart work harder to pump blood throughout the body.
- Hypertension (high blood pressure) pushes extra force on the artery walls, causing damage over time. Again, this also strains the heart muscle.
- High cholesterol causes plaque to build up on the walls of arteries, and the plaque hardens over time. This causes the artery walls to narrow and stiffen.
You and your doctor will work together to manage these risk factors. This is true no matter what your weight or BMI is. Managing risk factors may include heart-healthy lifestyle changes, such as reducing sodium and saturated fats in the diet. For some people, medications may also be helpful, such as statins to lower cholesterol. These options depend on your own unique health factors, so a conversation with your doctor is the best place to start.
David Anstey, MD, is a cardiologist at Columbia University Irving Medical Center.
- Adult obesity facts. Atlanta, GA: Centers for Disease Control and Prevention. (Accessed on July 4, 2021)
- Diabetes, heart disease, & stroke. Bethesda, MD: National Institute of Diabetes and Kidney Diseases, 2021. (Accessed on July 4, 2021)
- Metabolic syndrome (insulin resistance syndrome or syndrome X). Waltham, MA: UpToDate, 2021. (Accessed on July 12, 2021)