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Wednesday, 30 October 2013
#Obesity and Peripheral Vascular Disease
A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.
B. How to calculate your BMI index
BMI= weight (kg)/ height (m2)
C. Peripheral Vascular Disease is defined as a condition of obstruction of arteries as a result of hardening and narrowing of the arteries which supply blood to the lower extremity.
D. How Obesity associates with Peripheral Vascular Disease
According to the study of "Abdominal obesity and peripheral vascular disease in men and women: a comparison of waist-to-thigh ratio and waist circumference as measures of abdominal obesity" by Lu B, Zhou J, Waring ME, Parker DR, Eaton CB., posted in PubMed, researchers indicated in abstract that WTR is associated with PVD in men and women. In contrast, WC is associated with PVD in women, but not in men. Well-controlled prospective studies are needed to assess these two measures of body fat distribution and its association with the development of PVD in men and women.
2.In a study of "The risk of general and abdominal adiposity in the occurrence of new vascular events and mortality in patients with various manifestations of vascular disease" by Kanhai DA, Kappelle LJ, van der Graaf Y, Uiterwaal CS, Visseren FL., posted in PubMed, researchers found that :General adiposity is associated with an increased risk for vascular mortality in CAD patients and a decreased risk for (vascular) mortality in PAD patients.International Journal of Obesity.
3. In the study of "Patients with coronary, cerebrovascular or peripheral arterial obstructive disease differ in risk for new vascular events and mortality: the SMART study" by Achterberg S, Cramer MJ, Kappelle LJ, de Borst GJ, Visseren FL, van der Graaf Y, Algra A; SMART study Group., posted in PubMed, researchers found that Patients with a recent CVD or PAOD have almost twice the risk for future vascular events than those with CAD.
4. According to the study of "Peripheral vascular disease and peripheral neuropathy in individuals with cardiometabolic clustering and obesity: National Health and Nutrition Examination Survey 2001-2004" by Ylitalo KR, Sowers M, Heeringa S., posted in PubMed, researchers suggested that Obesity and clustering markedly increased the likelihood of LEDs in this sample and identified a group for whom preventive activities may reduce the risk of future disability.
5. In the abstract of "Obesity and fat distribution as predictors of aortoiliac peripheral arterial disease in middle-aged men" by Jakovljević B, Stojanov V, Lović D, Paunović K, Radosavljević V, Tutić I., posted in PubMed, researchers found that This study has identified the quantity of fat tissue (body fat over 26.5%) and its visceral distribution (waist-hip ratio over 1.02) as predictors of aortoiliac PAD in middle-aged men. Body mass index, a crude indicator of obesity, should be combined with these parameters when assessing the risk for aortoiliac PAD.
6. in the study of "Relationship of obesity distribution and peripheral arterial occlusive disease in elderly men" by Planas A, Clará A, Pou JM, Vidal-Barraquer F, Gasol A, de Moner A, Contreras C, Marrugat J., posted in PubMed, the study indicated that Abdominal fat distribution, but not total body fatness, is associated with peripheral arterial occlusive disease, independently of concurrent cardiovascular risk factors.
E Treatments of Obesity and Peripheral Vascular Disease
1. In abstract of the study of "The prognostic impact of general and abdominal obesity in peripheral arterial disease" by Giugliano G, Brevetti G, Laurenzano E, Brevetti L, Luciano R, Chiariello M., posted in PubMed, researchers concluded that Abdominal obesity and, to a lesser degree, general obesity worsen the prognosis of PAD patients independently of possible confounding factors. Weight reduction should be integrated in the active management of these patients.
2. According to the abstract of "The management of combined coronary artery disease and peripheral vascular disease" by Cassar A, Poldermans D, Rihal CS, Gersh BJ., posted in PubMed, researchers wrote that Coronary artery disease (CAD) and peripheral vascular disease (PVD) remain highly prevalent in the population due to population ageing, smoking, diabetes, unhealthy lifestyles, and the epidemic of obesity, and frequently coexist. The management of combined CAD and PVD is a common challenge and brings with it numerous clinical dilemmas. The goal of this article is to review the prevalence of PVD and its major impact upon prognosis in patients with known CAD and in turn to review the impact of CAD upon the prognosis of patients with PVD. This review will also highlight issues related to the peri-operative evaluation and management of patients going to vascular surgery, including medical optimization as well as the performance and timing of coronary revascularization.
3. In the study of "Angio-Seal use in patients with peripheral arterial disease (ASPIRE)" by Katzenschlager R, Tischler R, Kalchhauser G, Panny M, Hirschl M., posted in PubMed, researchers wrote that Complications (2 minor bleedings, 1 pseudoaneurysm) were not associated with high risk groups (these were: 69 antegrade punctures, 22 obese and 32 hypertensive patients). Three-month postinterventional diameter and blood velocity changes were <1%., and concluded that patients with peripheral arterial disease in the region of the puncture site and patients at higher complication risk can safely and effectively be closed with an Angio-Seal device. At the puncture site, no lumen change can be observed 3 months postinterventional.
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