Research
Hormonal
Obesity increases cardiovascular risk and mortality primarily through visceral adiposity and ectopic fat deposition (pericardial/epicardial), which drive endothelial dysfunction, chronic inflammation, and atherosclerosis, independent of or additive to traditional risk factors like BMI, blood pressure, and cholesterol.
Focus on reducing visceral and ectopic fat, not just total weight. Measures like waist circumference are more predictive of heart disease risk than BMI. Lifestyle interventions, particularly aerobic exercise, can reduce visceral adipose tissue even without significant weight loss, thereby lowering cardiovascular risk.
GoodSupportsHIGH confidence
Obesity is considered a storm, which accelerates this process by several mechanisms such as insulin resistance through adipocytokines, endothelial dysfunction, hypercoagulability, and inflammation. The VAT makes systemic and vascular inflammation that promotes atherogenesis... Another important causative factor is the ectopic fat deposition, especially pericardial and epicardial spaces, which may further contribute to the burden of coronary atherosclerosis.
Why this rating
The paper synthesizes multiple prospective epidemiological studies and mechanistic reviews, though it is a chapter rather than a single primary trial.
Source
Obesity and Cardiovascular Risk
P. Velasco · IntechOpen eBooks · 2023
DOI 10.5772/intechopen.106877
book_chapterCited 2×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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- Aerobic exercise reduces visceral adipose tissue (VAT) independently of weight loss, and 150 minutes per week is sufficient for this reduction, whereas resistance training effects on VAT are equivocal.Good
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