As the prevalence of obesity continues to grow worldwide, the health and financial burden of obesity-related comorbidities grows too. Cardiovascular disease (CVD) is clearly associated with increased adiposity. Importantly, women are at higher risk of CVD when obese and insulin resistant, in particular at higher risk of developing heart failure with preserved ejection fraction and ischemic heart disease. Increased aldosterone and mineralocorticoid receptor activation, aberrant estrogenic signaling and elevated levels of androgens are among some of the proposed mechanisms explaining the heightened CVD risk. In addition to traditional cardiovascular risk factors, understanding nontraditional risk factors specific to women, like excess weight gain during pregnancy, preeclampsia, gestational diabetes, and menopause are central to designing personalized interventions aimed to curb the epidemic of CVD. In the present review, we examine the available evidence supporting a differential cardiovascular impact of increased adiposity in women compared with men and the proposed pathophysiological mechanisms behind these differences. We also discuss women-specific cardiovascular risk factors associated with obesity and insulin resistance.

中文翻译：

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女性肥胖和心血管疾病。

随着肥胖症在世界范围内的流行率持续增长，与肥胖症相关的合并症的健康和经济负担也在增加。心血管疾病 (CVD) 显然与肥胖增加有关。重要的是，女性在肥胖和胰岛素抵抗时患 CVD 的风险更高，尤其是发生射血分数保留的心力衰竭和缺血性心脏病的风险更高。醛固酮和盐皮质激素受体激活增加、雌激素信号异常和雄激素水平升高是解释 CVD 风险增加的一些拟议机制。除了传统的心血管危险因素，了解女性特有的非传统危险因素，如怀孕期间体重增加过多、先兆子痫、妊娠糖尿病、和更年期是设计旨在遏制 CVD 流行的个性化干预措施的核心。在本综述中，我们检查了现有证据，支持女性与男性肥胖增加对心血管的影响不同，以及这些差异背后的病理生理机制。我们还讨论了与肥胖和胰岛素抵抗相关的女性特有的心血管危险因素。