心力衰竭论坛
    More than half of the German are overweight (BMI 25~29.9 kg/m2) and another 20% German are obese (BM≥30 kg/m2). Overweight and obesity are generally thought to elevate morbidity and mortality. Obese patients could be effectively treated with gastric band surgery， but recent studies question the negative association between BMI and morbidity and mortality in overweight population. The recent statistical report documented increased life expectancy in Germany. Data from 27 meta-analyses and 15 cohort studies showed that the overall mortality of overweight persons is not higher than that of normal weight (BMI 18.5~24.9 kg/m2) persons. In overweight population， morbidity and mortality are markedly influenced by the patient’s age， gender， ethnic origin， and social status. Dual source CT evidenced the association between pericardial adipose tissue but not BMI as a risk of coronary atherosclerosis. Thus， if overweight people do not carry other risk factors including smoking， physical inactivity， high blood pressure， diabetes， dyslipidemia and sleep apnea， they should enjoy the status of “healthy/benign overweight”. Overweight people with other risk factors should control the risk factors mostly by effective medications. Most antihypertensive， lipid-lowering medications also have beneficial anti-inflammatory effects by reducing ROS production through inhibiting NADPH-oxidase/xanthine oxidase which lead to free radical production reduction and endothelial function improvement. Notably， Overweight provides somewhat protective effect for patients with chronic heart failure(CHF). Studies showed identical survival results favor to overweight HF patients. However， the underlying mechanisms for the beneficial impact of overweight in HF patients remain unknown. Reduced sympathetic activity， lower inflammatory cytokine levels， protective role of cholesterol in overweight HF patients might be linked the superior survival in these patients compared to HF patients with normal and low BMI. Future studies are warranted to clarify the potential reasons for the observed phenomenon.