Obesity as a risk factor for stroke

The World Health Organization (WHO) estimates that approximately 2.5 billion people are overweight and that 890 million are living with obesity1. Obesity is associated with diets that are high in unhealthy fats and sugars and physical inactivity. But many other factors, including genetics, biological and social influences can affect how the disease progresses.

The WHO recognises that tackling obesity should be seen as a societal rather than an individual responsibility. This would mean ensuring people have access to affordable, healthy food options and opportunities to exercise.

An overweight or obesity diagnosis is made by measuring a person’s weight and height, and by calculating the body mass index (BMI): weight (kg)/height² (m²). The BMI is a rough indicator of the amount of body fat someone has. Additional measurements, such as waist circumference, and in some cases, MRI scans, can help to diagnosis obesity1.

How does obesity lead to stroke?

Obesity is often associated with high blood pressure, because excess body fat increases the workload on the heart. This can lead to damage to blood vessels. In addition, it is a significant risk factor for developing type 2 diabetes, which can damage blood vessels and nerves, impairing blood flow and increasing the likelihood of blood clots.

Obesity is also frequently linked to high levels of cholesterol and triglycerides in the blood, which can contribute to the build-up of plaque in the arteries (atherosclerosis). This narrows the arteries and restricts blood flow, increasing the risk of stroke. It can also lead to chronic inflammation and is a risk factor for atrial fibrillation, both of which are risk factors for stroke2,3,4,5.

Around 30% of people who are overweight have three or more of these risk factors. For people with obesity, this rises to over 60%3.

Obesity and stroke risk: Key points

Living with obesity can develop a range of conditions that cause stroke, including high blood pressure and diabetes. The WHO recommends that obesity is treated in the same way as other non-communicable diseases (NCDs) and should be integrated into existing NCD pathways1.

There are a variety of medications and surgeries available for people with obesity who also have other cardiovascular risk factors.

In addition, the familiar lifestyle advice is important:

  • Eat a balanced diet
  • Take regular exercise
  • Keep track of your blood pressure, blood sugar and cholesterol levels
  • Quit smoking
  • Maintain a healthy weight

 

Read about medical interventions for obesity

Read about surgical interventions for obesity

References

  1. World Health Organization. Health service delivery framework for prevention and management of obesity. 2023. 9789240073234-eng.pdf (who.int)
  2. CN Lumeng, AR Saltiel. Inflammatory links between obesity and metabolic disease. J Clin Invest. 2011. 121:2111–2117. https://doi.org/10.1172/JCI57132
  3. TJ Wang, H Parise, RB D’Agostino, PA Wolf, RS Vasan, EJ Benjamin. Obesity and the risk of new-onset atrial fibrillation. JAMA. 2004. 292:2471–2477. https://doi.org/10.1001/jama.292.20.2471
  4. P Mathieu, I Lemieux, JP Després. Obesity, inflammation, and cardiovascular risk. Clin Pharmacol Ther. 2010. 87:407–416. https://doi.org/10.1038/clpt.2009.311
  5. V Bamba, DJ Rader. Obesity and atherogenic dyslipidemia. Gastroenterology. 2007. 132:2181–2190. https://doi.org/10.1053/j.gastro.2007.03.056
  6. T Huai Shi, B Wang, S Natarajan. The influence of metabolic syndrome in predicting mortality risk among US adults: Importance of metabolic syndrome even in adults with normal weight. Prev Chronic Dis. 2020. May 21:17:E36. https://doi.org/10.5888/pcd17.200020

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