Exercise physiology in obese subjects: Cardiovascular function

Humans are not genetically programmed to be inactive: the combination of both a sedentary lifestyle and unrestricted food availability increases the prevalence of obesity and type 2 diabetes, and therefore the risk of cardiovascular morbidity and mortality. Cardiovascular function is altered in the obese: left ventricular hypertrophy, reduced diastolic and systolic function, chronotropic incompetence, a high prevalence of arterial hypertension, diabetes, coronary artery disease and atrial fibrillation are typical features of the obesity cardiomyopathy. Exercise can be seen as one of our most potent strategies for resistance against obesity and its consequences, and could possibly prevent or reverse the anomalies in cardiovascular function. In this chapter, the modifications that occur in cardiac structure and function of obese subjects, the peculiar response to exercise, and the main effects of body weight loss and physical training on the cardiovascular system are reviewed.