Risk Stratification and Treatment of Obesity for Primary and Secondary Prevention of Cardiovascular Disease

• Published in: Current atherosclerosis reports Vol. 26; no. 1; pp. 11 - 23
• Main Authors: Ostrominski, John W., Powell-Wiley, Tiffany M.
• Format: Journal Article
• Language: English
• Published: New York Springer US 2024
• Subjects: Angiology; Cardiology; Cardiovascular Diseases - complications; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Humans; Medicine; Medicine & Public Health; Obesity - complications; Obesity - epidemiology; Obesity - therapy; Review; Risk Assessment - methods; Risk Factors; Secondary Prevention; Topical Collection on Cardiometabolic Disease and Treatment; Prevention; Pharmacotherapy; Obesity; Cardiometabolic disease; Social determinants of health; Weight management
• ISSN: 1523-3804; 1534-6242
• DOI: 10.1007/s11883-023-01182-3

Purpose of Review In this review, we discuss contemporary and emerging approaches for risk stratification and management of excess adiposity for the primary and secondary prevention of cardiovascular disease. Recent Findings Obesity is simultaneously a pandemic-scale disease and major risk factor for the incidence and progression of a wide range of cardiometabolic conditions, but risk stratification and treatment remain clinically challenging. However, sex-, race-, and ethnicity-sensitive anthropometric measures, body composition–focused imaging, and health burden–centric staging systems have emerged as important facilitators of holistic risk prediction. Further, expanding therapeutic approaches, including comprehensive lifestyle programs, anti-obesity pharmacotherapies, device/endoscopy-based interventions, metabolic surgery, and novel healthcare delivery resources offer new empowerment for cardiovascular risk reduction in individuals with obesity. Summary Personalized risk stratification and weight management are central to reducing the lifetime prevalence and impact of cardiovascular disease. Further evidence informing long-term safety, efficacy, and cost-effectiveness of novel approaches targeting obesity are critically needed.