Which statement best describes obesity's impact on cardiovascular structure and risk?

• A. Obesity reduces inflammation and improves endothelial function
• B. Obesity has no impact on cardiovascular risk
• C. Obesity increases LVH and diastolic dysfunction via inflammatory and mechanical effects
• D. Obesity only affects lipid levels

Answer: (C)

Obesity drives changes in heart structure and raises cardiovascular risk through two main paths: mechanical load and systemic inflammation. The heart has to handle a larger blood volume and higher cardiac output, which increases wall stress and preload. Over time this chronic load promotes left ventricular remodeling and hypertrophy, and it compromises the ventricle’s ability to relax, leading to diastolic dysfunction. At the same time, excess adipose tissue creates a persistent proinflammatory state with cytokines and adipokines that promote myocardial fibrosis and endothelial dysfunction, further worsening stiffness and vascular disease. Together, these inflammatory and mechanical effects explain why obesity is linked to LV hypertrophy and diastolic dysfunction, and to higher cardiovascular risk overall.

The other statements don’t fit: obesity is not about reduced inflammation or improved endothelial function; it clearly increases inflammation and risk. It does impact cardiovascular risk beyond lipids, so saying it has no impact or only affects lipid levels misses the structural and functional heart changes you’d expect with obesity.