Possible Paradigm Shift in Heart Disease Treatment
A new understanding of obesity may have a significant impact on the treatment of cardiovascular risk factors and heart disease.
Research into the endocannabinoid system may lead to new ways to combat obesity, a major risk factor for heart disease. Researchers believe the EC system acts as a coordinator of a variety of processes in the body that regulate body weight, energy balance and blood sugar levels.
"It seems as though the EC system receptors are overactivated when 'fattening foods' are consumed and weight is gained," said Dr. Louis Aronne, director of the Comprehensive Weight Control Program at the New York-Presbyterian Hospital/Weill Cornell Medical Center.
"This overactivation leads to ... more fat production in the liver. Eventually, what starts out as just eating the wrong foods will lead to the development of obesity, cardiometabolic risks and heart disease."
Blocking these receptors may help patients lose weight, thereby reducing obesity and other risk factors for heart disease.
Clinical trials on receptor-blocking drugs are under way.
"In the future, we'll see a paradigm shift, or a change in the treatment of cardiometabolic risk," Aronne said. "Instead of waiting for risk factors and disease to emerge, we'll be treating those who are obese earlier and earlier to prevent disease and offset complications."
Meanwhile, the best advice to patients is to manage all their risk factors for cardiovascular disease.
"The more risk factors someone has, the more likely he or she is to have cardiovascular disease," explained Dr. Antonio Gotto Jr., dean and professor of medicine at the Weill Medical College of Cornell University in New York. "In cases where patients have two or more risk factors, the heart disease risk caused by the whole package is much worse than the risk associated with each individual risk factor."
In essence, this theory can also apply to prevention and management of risk factors; the more risk factors managed, the greater chance a patient can prevent heart disease.
"Research into risk has been extremely beneficial in giving physicians a better understanding of how they can help their patients," said Gotto. "We've learned that without management of all the issues related to one's cardiovascular health, it is very unlikely patients will reduce risk substantially and prevent disease."
Author: Richard Lewis
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