Gilad Margolis1,2, Gabby Elbaz-Greener3,4, Jeremy N Ruskin5, Ariel Roguin1,2, Offer Amir3,4, Guy Rozen6,7,8. 1. Division of Cardiovascular Medicine, Cardiac Electrophysiology Unit, Hillel Yaffe Medical Center, Hadera, Israel. 2. The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. 3. Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel. 4. Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. 5. Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA. 6. Division of Cardiovascular Medicine, Cardiac Electrophysiology Unit, Hillel Yaffe Medical Center, Hadera, Israel. dr.rozen@gmail.com. 7. The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. dr.rozen@gmail.com. 8. Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA. dr.rozen@gmail.com.
Abstract
PURPOSE OF REVIEW: We aimed to describe the epidemiology of sudden cardiac death (SCD) in the obese, elaborating on the potential pathophysiological mechanisms linking obesity, SCD, and the outcomes in SCD survivors, as well as looking into the intriguing "obesity paradox" in these patients. RECENT FINDINGS: Several studies show increased mortality in patients with BMI > 30 kg/m2 admitted to the hospital following SCD. At the same time, other studies have implied that the "obesity paradox," described in various cardiovascular conditions, applies to patients admitted after SCD, showing lower mortality in the obese compared to normal weight and underweight patients. We found a significant body of evidence to support that while obesity increases the risk for SCD, the outcomes of obese patients post SCD are better. These findings should not be interpreted as supporting weight gain, as it is always better to prevent the "disaster" from happening than to improve your chances of surviving it. Obesity is shown to be significantly associated with increased risk for SCD; however, there is a growing body of evidence, supporting the "obesity paradox" in the survival of SCD victims. Prospectively, well-designed studies are needed to confirm these findings.
PURPOSE OF REVIEW: We aimed to describe the epidemiology of sudden cardiac death (SCD) in the obese, elaborating on the potential pathophysiological mechanisms linking obesity, SCD, and the outcomes in SCD survivors, as well as looking into the intriguing "obesity paradox" in these patients. RECENT FINDINGS: Several studies show increased mortality in patients with BMI > 30 kg/m2 admitted to the hospital following SCD. At the same time, other studies have implied that the "obesity paradox," described in various cardiovascular conditions, applies to patients admitted after SCD, showing lower mortality in the obese compared to normal weight and underweight patients. We found a significant body of evidence to support that while obesity increases the risk for SCD, the outcomes of obese patients post SCD are better. These findings should not be interpreted as supporting weight gain, as it is always better to prevent the "disaster" from happening than to improve your chances of surviving it. Obesity is shown to be significantly associated with increased risk for SCD; however, there is a growing body of evidence, supporting the "obesity paradox" in the survival of SCD victims. Prospectively, well-designed studies are needed to confirm these findings.
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