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Given the clinical importance of cardiovascular disease as the number one cause of death world wide, it is important that we seek underlying causes of cardiovascular morbidity and mortality. A comprehensive approach to cardiometabolic disease may yield greater clinical benefit than continuing to focus on managing individual risk factors.
Abdominal obesity, with its attendant intra-abdominal adiposity, is emerging as an underlying cause of multiple cardiovascular risk factors. Intra-abdominal adipocytes are active endocrine cells, secreting a range of substances that adversely affect cardiometabolic risk factors associated with the metabolic syndrome, such as lipid profiles, insulin sensitivity and glucose tolerance, and also emerging risk factors, including inflammation and altered haemostasis.
Recent research shows that over-activity of the endocannabinoid system, acting through the CB1 receptor, exacerbates multiple cardiometabolic risk factors. Selective CB1 receptor blockade provides a new therapeutic approach to the simultaneous management of multiple cardiometabolic risk factors, particularly in patients with intra-abdominal adiposity. These patients can be easily identified using standard waist measurement in conjunction with other cardiometabolic markers such as HDL, triglycerides, glucose or blood pressure.
This presentation reviews the relationships between abdominal obesity, intra-abdominal adiposity, and elevated cardiometabolic risk, and outlines the potential role of selective CB1 receptor blockade in the management of multiple cardiovascular risk factors.
