As will be clear from other chapters of this book, many of the co-morbidities of obesity are inter-related. This is especially true of cardiovascular disease which usually does not occur as an isolated problem but which is found in subjects already suffering from a range of obesity co-morbidities. 1,2 The management of the heart problems of obesity are then complicated by having to consider treatment (a) for the obesity itself, (b) for any other co-morbidities (such as hypertension) that promote cardiovascular problems and (c) for the cardiac problems per se. Similar complexity affects any discussion of the relationship between obesity and cardiovascular disease.
The co-morbidities associated with obesity are shown in Table 4.1. Of these conditions, some such as arthritis and psychological problems are more likely to cause distress than be a direct cause of mortality. Other co-morbidities such as diabetes and nocturnal hypoventilation cause morbidity directly and also indirectly contribute to mortality (Chapters 2