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Cadernos de Saúde Pública

On-line version ISSN 1678-4464Print version ISSN 0102-311X


SCARSELLA, Carla  and  DESPRES, Jean-Pierre. Treatment of obesity: the need to target attention on high-risk patients characterized by abdominal obesity. Cad. Saúde Pública [online]. 2003, vol.19, suppl.1, pp.S7-S19. ISSN 1678-4464.

Abdominal obesity is associated with metabolic abnormalities, increasing the risk of type 2 diabetes and coronary artery disease (CAD). The Quebec Cardiovascular Survey demonstrated that the atherogenic metabolic triad (AMT) present in abdominally obese (AO) males increases the risk of CAD 20-fold over the course of 5 years. An early detection algorithm was developed to identify individuals presenting these atherogenic abnormalities. It was found that the association of large waist circumference (WC) and moderate hypertriglyceridemia (the "hypertriglyceridemic waist", or HW) could adequately identify a significant portion of individuals with the AMT. It is important to note that even in the absence of classic risk factors, abdominally obese patients can present increased risk of CAD if they have HW. Finally, it has been suggested that the risk of developing an acute coronary syndrome in AO patients is not always related to the degree of coronary stenosis, and the patient’s atherothrombotic/inflammatory profile should be taken into account in evaluating risk. Stabilization of the atherosclerotic plaque would become a legitimate therapeutic objective, and more feasible for prevention of CAD, in AO patients.

Keywords : Diabetes; Heart Diseases; Hypertriglyceridemia; Obesity.

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