Obesity is a common, preventable and ubiquitous disease of clinical andpublic health importance. It is often a major risk factor for the developmentof several non-communicable diseases, significant disability and premature deathObesity is defined as a condition of abnormal or excessive fataccumulation in adipose tissue, to the extent that health is impairedUntil recently the relation between obesity andcoronary heart disease was viewed as indirect, ie, through covariates relatedto both obesity and coronary heart disease risk, including hypertension; dyslipidemia,particularly reductions in HDL cholesterol (impaired lipid profile); andimpaired glucose tolerance or non–insulin-dependent diabetes mellitus (Type 2).
Insulin resistance and accompanying hyperinsulinemia are typically associatedwith these comorbidities. Althoughmost of the comorbidities relating obesity to coronary artery disease increaseas BMI increases, they also relate to body fat distribution. Long-termlongitudinal studies, however, indicate that obesity as such not only relatesto but predicts coronary atherosclerosis. This relation appears to exist forboth males and females with minimal increases in BMI.Body Mass Index (BMI) is a simple index of weight-for-height that iscommonly used to classify underweight, overweight and obesity in adults. The Body Mass Index (BMI) is widelyused for the determination of nutritional status or body composition.
It is thevalue obtained when the weight in kilograms is divided by the square of theheight in meters. Nutritional status is determined through BMI cut-offs valuesas recommended by the World Health Organization (WHO) however, in recent yearssome scientists in the Asia- Pacific region made recommendations that thecriteria values be modified to fit the Asian body composition, which is claimedto be different compared to the American or European body composition. Thus the”Asian criteria” for the determination of nutritional status based onthe BMI was born. The cold pressor test is a widely used and time testedexperimental technique for measuring autonomic functions, involving immersionof the hand or forearm in cold water. First documented as a test ofcardiovascular stress reactivity, its application has grown in investigation ofpain perception, mechanisms, and treatment is due to a gradually mountingpainful sensation of mild to moderate intensity. As water temperatures used arewithin the range considered noxious (below 15°C), nociceptors (pain receptors)are activated and transmit an aversive signal to the CNS. This test produces anincreased heart rate, total vascular resistance, arterial blood pressure andcardiac output.
These effects are attributed to increased sympathetic vasomotorneuronal activityChronicimbalance of the autonomic nervous system is prevalent and potent risk factorfor adverse cardiovascular events including mortality.Any factor that lead toinappropriate activation of the sympathetic nervous system.Any factor that leadto inappropriate activation of the sympathetic nervous system can be expectedto have an adverse effect on this measures. Any factor that increases vagaltone tends to improve outcomes.
Factors linking obesity to increase BP andblood volume and cardiac output that is caused by increased metabolic demand.