Editorial
Obesity, Heart Disease, and Favorable Prognosis—Truth or Paradox?

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    The data indicated that mild obesity could decrease short-term postoperative mortality, which was consistent with previous studies that postulated the existence of an obesity paradox in a mixed cardiac surgical population in terms of in-hospital outcomes and mortality.29-33 This beneficial effect may be related to the lower systemic vascular resistance and plasma renin activity of obese patients compared with leaner patients.34 In addition, overweight and obese patients have lower levels of circulating atrial natriuretic peptides, attenuated sympathetic nervous systems, and renin-angiotensin responses.35,36

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  • Low weight and overweightness in older adults: Risk and clinical management

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    Frailty and cardiac cachexia are additional concerns related to low body weight among the elderly, as they are associated with poor clinical prognosis in many conditions. In fact, a “lean paradox” may be present in which patients with both a low BF (< 25% in men and < 35% in women) and low BMI (< 25 kg/m2)34 or low LBM 33 do worse than normal weight counterparts. This paradox between BMI and mortality is also demonstrated by Childers’s mathematical model as seen in Fig. 1.51

  • Cardiac rehabilitation in the United States

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