cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2018-5-92-98cardiovascular-746Research ArticleОБЗОРЫREVIEWS“Парадоксы ожирения”: основные причины формирования “обратной” кардиоваскулярной эпидемиологии“Obesity paradoxes”: main causes of an “inverse” cardiovascular epidemiologyhttps://orcid.org/0000-0002-3147-9056ДружиловМ. А.DruzhilovM. A.

Дружилов Марк Андреевич — кандидат медицинских наук, начальник терапевтического отделения стационара.

Тел.: +7 (911) 403-19-48, +7 (8142) 73-88-48

Petrozavodsk

drmark1982@mail.ruhttps://orcid.org/0000-0002-6654-1382КузнецоваТ. Ю.KuznetsovaТ. Yu.

Кузнецова Татьяна Юрьевна — доктор медицинских наук, заведующий кафедрой факультетской терапии, фтизиатрии, инфекционных болезней и эпидемиологии медицинского института

eme@karelia.ruhttps://orcid.org/0000-0003-1685-1777ДружиловаО. Ю.DruzhilovaО. Yu.

Дружилова Ольга Юрьевна — аспирант кафедры факультетской терапии, фтизиатрии, инфекционных болезней и эпидемиологии медицинского института

astrahankinaolga@mail.ruМедико-санитарная часть Управления ФСБ России по Республике КарелияРоссияMedical and Sanitary Institution of the FSS in Karelia RepublicRussian FederationФГБОУ ВО Петрозаводский государственный университетРоссияPetrozavodsk State UniversityRussian Federation2018201020181759298Copyright © Дружилов М.А., Кузнецова Т.Ю., Дружилова О.Ю., 20182018Дружилов М.А., Кузнецова Т.Ю., Дружилова О.Ю.Druzhilov M.A., Kuznetsova Т.Y., Druzhilova О.Y.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/746

С учетом продолжающегося роста распространенности ожирения, в большинстве стран мира оно становится одной из главных проблем общественного здравоохранения. В структуре нозологических единиц, ассоциированных с наличием избыточной массы тела и ожирения, лидирует кардиоваскулярная патология. Вместе с тем, в исследованиях и мета-анализах последних десятилетий стали выявлять обратную взаимосвязь индекса массы тела и клинических исходов, характеризующуюся лучшей выживаемостью и меньшей частотой событий у лиц, имеющих более высокую величину показателя, с хроническими заболеваниями. Такие факты способствовали появлению многочисленных дискуссий в отношении прогностического влияния избыточной массы тела и ожирения и целесообразности их коррекции у лиц с сердечно-сосудистыми заболеваниями в рамках вторичной профилактики. В настоящей статье обсуждаются основные возможные причины формирования “обратной” кардиоваскулярной эпидемиологии при избыточном весе и ожирении.

Taken the continuous increase of obesity prevalence, most countries in the world deal with an epidemy, one of the main healthcare concerns. In the structure of nosology associated with overweight and obesity, cardiovascular is leading. Also, in the recent trials and meta analyses there is negative correlation found for body mass index and clinical outcomes characterizing better survival and lower events rate in those with higher BMI, as less chronic diseases. Such facts facilitated a number of discussions on the predictive value of overweight and obesity and consideration whether to correct those in cardiovascular patients as secondary prevention. Current article is focused on the main causes for an “inverse” cardiovascular epidemiology in overweight and obesity.

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The authors declare that there are no conflicts of interest present.