Determination of Absolute Risk Status Based on Overweight and Obesity Parameters
Determining the patient's absolute risk status requires consideration of the degree of overweight, as well as the presence of existing diseases or risk factors. To do so requires taking into account the patient's history, physical examination, and laboratory results. Of greatest urgency is the need to detect existing CVD or end-organ damage that trigger the need for intense risk factor modification as well as disease management. Since the major risk of obesity is indirect (obesity elicits or aggravates hypertension, dyslipidemias, and diabetes which cause cardiovascular complications), the management of obesity should be implemented in the context of these other risk factors. While there is no direct evidence demonstrating that addressing risk factors increases weight loss, treating the risk factors through weight loss is a recommended strategy.
[Methods for establishing absolute risk status for developing CVD, based on the risk factors, are described in detail in the National Cholesterol Education Program's Second Report of the Expert Panel on the Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP II) and in the Sixth Report of the Joint National Committee Report on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). The intensity of the intervention for high blood cholesterol or high blood pressure is adjusted depending on the absolute risk status estimated by these factors.]