抄録
Obesity constitutes a risk factor for the development of coronary heart disease (CHD). However, it is not fully investigated which facet (s) of obsity is responsible for the development of CHD, since obesity accompanies varieties of disorders including physical overloard of overweight to cardiovascular organs, high blood pressure, impaired pulmonary ventilation, and metabolic derangements of diabetes mellitus, hyperlipidemia and hyperuricemia.
To investigate the role of physical overload of overweight to cardiovascular system in the pathogenesis of CHD, we have collected 48 cases of myocardial infarction (MI) and 19 cases of latent coronary insufficiency (LCI). They were grouped into 4 subgroups according to presence and absence of hypercholesterolemia, hypertriglyceridemia and hypertension. The distribution of patients in the 4 groups were: 20% for MI and 14% for LCI in the group where all the three of serum cholesterol, triglyceride and blood pressure were abnormal, 30% and 57% in the group where at least the two of them were abnormal, 40% and 21% in the group where at least one of the three was abnormal, and finally 10% and 7% in the group where all the three were normal, respectively.
The frequency of ischemic heart disease was the lowest in the obese subjects but without any accompanying metabolic and circulatory disorders of hyperlipidemias and hypertension. This finding was also supported by the fact that the occurrence of hypercholesterolemia, hypertriglyceridemia and hypertension distributes almost uniformly in the range of 12 to 20% among the 4 groups of obese subjects made in the same way as with MI and LCI patients.
These imply that MI and LCI were induced more strongly by the metabolic and circulatory disorders of obesity rather than the long-term physical overload of overweight itself to cardiovascular organs. Therefore, when we have an obese patient accompnying metabolic or circulatory disturbances, we have to treat him with more cautions since he has a higher risk for the development of ischemic heart diseases.
