Doctor Le Ba Ngoc, Deputy Director of the Weight Control and Obesity Treatment Center at Tam Anh General Hospital, explained that obesity is often accompanied by metabolic disorders such as high blood pressure, type 2 diabetes, and dyslipidemia (abnormal blood fat levels). Prolonged high blood pressure damages artery walls, accelerating the atherosclerosis process, a leading cause of heart attacks. High levels of bad cholesterol (increased LDL and triglycerides, decreased HDL) facilitate fat accumulation within blood vessels.

Overweight and obese individuals often have excessive visceral fat, sometimes exceeding safe limits by several times. Visceral fat stores energy and acts as a complex endocrine organ, secreting inflammatory cytokines that cause chronic, low-grade inflammation. This damages the lining of blood vessels, allowing bad cholesterol (LDL) to accumulate and form plaque.

In obese individuals, insulin resistance and high blood sugar further contribute to atherosclerosis. They may develop serious cardiovascular diseases like heart attacks without realizing it, as the disease progresses silently with no obvious symptoms in the early stages.

Doctor Ngoc consults with a patient. *Illustrative photo: Tam Anh General Hospital*

Obesity impacts metabolism and alters the heart's structure and function. As body weight increases, the heart works harder to pump blood throughout the body, eventually leading to chamber dilation, thickening of the heart muscle, and chronic heart failure. Fat surrounding the heart (pericardial fat) can compress the heart, increasing the risk of arrhythmias.

Obesity is closely linked to sleep apnea. Repeated episodes of breathing cessation during sleep cause intermittent blood oxygen shortages, stimulating the sympathetic nervous system, leading to increased blood pressure and arrhythmias.

For example, Mr. Quan, 65, 1.67m tall, weighing 85 kg, visited Tam Anh General Hospital in Hanoi with a BMI of 30.5 kg/m2, indicating class 2 obesity. With 159 cm2 of visceral fat and a 102 cm waist circumference, Mr. Quan had dyslipidemia, hypertension, high blood sugar, and a family history of acute myocardial infarction (heart attack). A coronary CT scan revealed up to 70% blockage in his coronary arteries, with some areas narrowed by 90% due to large plaques.

He underwent timely cardiac intervention to prevent a heart attack or stroke. After treating his heart condition, doctors developed a personalized plan for Mr. Quan to manage his weight and reduce the risk of recurrence.

The Somatom Force VB30 CT scanner can detect early heart damage. *Photo: Tam Anh General Hospital*

Doctor Ngoc advises individuals with a BMI of 25 kg/m2 or higher, or a large waist circumference (over 80 cm for women and 90 cm for men), who experience frequent fatigue and shortness of breath during physical activity, to seek medical attention and treatment for obesity. "Losing 10% of body weight helps reduce risk factors for cardiovascular disease," he stated. Managing weight, diagnosing, and treating underlying conditions are crucial for preventing serious complications and protecting long-term cardiovascular health.

Mai Anh