Obesity paradox

The prevalence and incidence of obesity has increased significantly in recent years, turning into the first case of chronic non-communicable disease with epidemic characteristics. Numerous scientific studies have shown that excessive weight is associated with an increased of morbidity and mortality, especially cardiovascular. Nevertheless, several clinical investigations have demonstrated the existence of the so-called "obesity paradox". Therefore patients with cardiovascular diseases and overweight have less complication during hospitalizations, reduced risk of sudden death and better prognosis in the short and long term than those with normal or underweight. These confusing data could be explained by many reasons: lack of discrimination of body mass index to differentiate between body fat and lean mass, a lower systemic vascular resistance, lower activity of plasma rennin and specific neuroendocrine profile with low levels of natriuretic peptide atrial observed in the obese people.