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Obesity and cardiovascular risk: a call for action from the European Society of Hypertension Working Group of Obesity, Diabetes and the High-risk Patient and European Association for the Study of Obesity part B obesity-induced cardiovascular disease, early prevention strategies and future research directions

Kotsis, Vasiliosa; Tsioufis, Konstantinosb; Antza, Christinaa; Seravalle, Ginoc; Coca, Antoniod; Sierra, Cristinad; Lurbe, Empare,f; Stabouli, Stellag; Jelakovic, Bojanh; Redon, Josepi; Redon, Paui; Nilsson, Peter, M.j; Jordan, Jensk; Micic, Dragank; Finer, Nicholasl; Leitner, Deborah, R.m; Toplak, Hermannn; Tokgozoglu, Laleo; Athyros, Vasiliosp; Elisaf, Mosesq; Filippatos, Theodosios, D.r; Grassi, Guidos,t

doi: 10.1097/HJH.0000000000001731

Obesity predisposes for atrial fibrillation, heart failure, sudden cardiac death, renal disease and ischemic stroke, which are the main causes of cardiovascular hospitalization and mortality. As obesity and the cardiovascular effects on the vessels and the heart start early in life, even from childhood, it is important for health policies to prevent obesity very early before the disease manifestation emerge. Key roles in the prevention are strategies to increase physical exercise, reduce body weight and to prevent or treat hypertension, lipids disorders and diabetes earlier and efficiently to prevent cardiovascular complications.

a3rd Department of Internal Medicine, Hypertension-24 h ABPM ESH Center of Excellence, Papageorgiou Hospital, Aristotle University of Thessaloniki

bFirst Cardiology Clinic, Medical School, National and Kapodistrian University of Athens Hippokration Hospital, Athens, Greece

cCardiology Department Istituto Auxologico Italiano, S. Luca Hospital, Milano, Italy

dHypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic of Barcelona (IDIBAPS), University of Barcelona

ePediatric Department, Consorcio Hospital General, University of Valencia, Valencia

fCIBERObn (CB06/03) Instituto de Salud Carlos III, Madrid, Spain

g1st Department of Pediatrics, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

hDepartment of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Croatia

iINCLIVA Research Institute, University of Valencia, Valencia, Spain

jDepartment of Internal Medicine, Skåne University Hospital, Malmö, Sweden

kInstitute for Clinical Pharmacology, Medical School Hannover, Hannover, Germany

lCenter for Obesity, Clinic for Endocrinology, Diabetes and Diseases of Metabolism Clinical Center of Serbia, Serbia

mNational Centre for Cardiovascular Prevention and Outcomes, UCL Institute of Cardiovascular Science, UK

nDepartment of Medicine, Medical University Graz, Graz, Austria

oDepartment of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey

pSecond Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki

qDepartment of Internal Medicine, School of Medicine, University of Ioannina, Ioannina

rDepartment of Internal Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece

sClinica Medica, School of Medicine and Surgery, Milano-Bicocca University

tIRCCS Multimedica, Sesto San Giovanni, Milan, Italy

Correspondence to Professor Vasilios Kotsis, MD, PhD, Hypertension-ABPM Center, Papageorgiou Hospital, Chairman, Working Group on Obesity, Diabetes and the high risk patients, 39 Zaka, Panorama 55236, Thessaloniki, Greece. Tel: +30 6974748860; fax: +30 2310452429; e-mail:

Abbreviations: ACE, angiotensin-converting enzyme; ARBs, angiotensin receptor blockers; BP, blood pressure; BSA, body surface area; CCBs, calcium channel blockers; CKD, chronic kidney disease; CRF, cardiorespiratory fitness; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease; GLUT1, glucose transporter 1; HIIT, high-intensity interval training; IFNγ, interferon gamma; MHO, metabolically healthy obesity; MICT, moderate-intensity continuous training; OSA, obstructive sleep apnea; RAS, renin–angiotensin system; SCD, sudden cardiac death; SNS, sympathetic nervous system; SREBP, sterol regulatory element-binding protein; TGF, transforming growth factor

Received 8 February, 2018

Revised 18 February, 2018

Accepted 23 February, 2018

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