Reacción a "The treatments have leveled off cholesterol and blood pressure levels in adults over 40 with and without obesity, according to a study"

As always, The Lancet has published another excellent article based on a large database of nearly one million adults in developed industrialized countries. However, this data should be used with caution, as it comes from observational studies with large populations, which can establish relationships but never causality. We must always remember this.

The study is interesting because it analyzes data on body mass index, blood pressure, and cholesterol levels from this population. In practical terms, I would highlight that over time we have become more aware that people with obesity have a high cardiovascular risk. This is evidenced by the higher prevalence of cardiovascular events and comorbidity associated with obesity, such as hypertension, high cholesterol, and diabetes.

We have increasingly better therapeutic tools that can bring blood pressure and cholesterol levels in people with and without obesity back to the same level. However, we must be cautious with this message because we know that people with obesity have a high cardiovascular risk, which is why they are being treated for hypertension and cholesterol. But the cardiovascular risk doesn't disappear; it remains. This study failed to include diabetes, low-grade chronic inflammation, and cancer. Obesity is a much greater risk factor than hypertension and cholesterol alone.

The study is very good, of high quality, and the news is positive: we are increasingly better at treating high blood pressure and cholesterol, and this could lead to a reduction in the cardiovascular risk associated with obesity in adults. However, we must emphasize that obesity has not become benign or controllable, because treating obesity means treating the root cause of the problem, and the root cause is metabolic and adiposopathy. It's not just about treating the consequences of obesity. Furthermore, this study overlooks many of the more than 200 complications associated with metabolic syndrome, which is a cardio-renal condition linked to obesity, such as diabetes, fatty liver disease, kidney disease, cancer, and sleep problems.

Obesity remains a major clinical problem. Treating obesity means addressing each and every cardiovascular risk factor, from its metabolic origin, without neglecting any of them. It's a treatment we call comprehensive, and we must be aware that it's crucial to address the root cause and prevent it in its early stages.

My headline would be that time is of the essence when treating obesity and its cardiovascular complications; time is of the essence for prevention and for initiating the correct treatment for this chronic and complex disease.