Association of body mass index with mortality in cardiovascular disease: New insights into the obesity paradox from multiple perspectives

Over the past 4 decades, prevalence of obesity has increased rapidly at both the national and global level and presents a major public health challenge. Obesity is associated with increased risk of morbidity from cardiovascular diseases. Data suggesting that the presence of obesity may be protective in individuals with clinically manifest cardiovascular disease have led to discussion of an “obesity paradox” stirring controversy and leading to unclear messaging regarding the true health risks of excess weight. This review explores the relationship between obesity and fatal and non-fatal outcomes in patients with prevalent cardiovascular disease and offers novel insights into the obesity paradox.