The Concept of CMR
Epidemiological studies published over the last 50 years have shed light on the many factors that increase cardiovascular disease (CVD) risk. It is now widely accepted that an altered lipid profile including high cholesterol, LDL cholesterol (bad cholesterol), and triglyceride concentrations as well as low HDL cholesterol (good cholesterol), high blood pressure, smoking, and a sedentary lifestyle all increase one’s risk of CVD. Also considered a major CVD risk factor, type 2 diabetes is defined by high blood glucose levels. Though obesity is an acknowledged health hazard and a risk factor for CVD and type 2 diabetes, physicians have long been puzzled by the remarkable heterogeneity seen in clinical practice among individuals with similar excess body weight. Some obese patients have no clinical signs of CVD or type 2 diabetes, whereas other patients—who may be only slightly or moderately overweight—have a metabolic profile that predisposes them to CVD and/or type 2 diabetes. Studies have shown that the risk of CVD and type 2 diabetes does not depend on excess body weight per se, but rather on the location of this excess weight. Excess abdominal fat plays the greatest role in this regard.