Obesity has reached epidemic proportions both in the United States and worldwide. There are numerous adverse effects on cardiac structure, hemodynamics, and cellular abnormalities, as well as increases in cardiovascular disease (CVD) risk factors such as hypertension, coronary heart disease, dyslipidemia, atrial fibrillation, and depression. Despite these overwhelming findings, large amounts of evidence support the presence of an "obesity paradox," where obese patients with CVD have a better prognosis than do lean or normal weight in patients with CVD. This review discusses the role of obesity in CVD risk factors and the implications of the obesity paradox in this subset of patients.
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