If you are slightly overweight, this alone does not signif¬icantly increase your risk of having a heart attack, hyper¬tension, or diabetes provided that you do not already have the risk factors — a family history of heart attacks occurring at an early age (before age 55), hypertension, high blood cholesterol, diabetes, smoking, and a stressful lifestyle. Obesity is different from being mildly overweight.
A. Coronary Heart Disease
The Framingham Study showed that in the 5000 people studied, being overweight appeared to increase the risk of sudden death and angina, but it did not increase the frequency of heart attacks. When adjustments were made for the prevalence of hypertension and hypercholesterol-emia, then being overweight or obesity appeared to play a much less significant role.
If a patient with coronary heart disease manifested by recurrent chest pain on exertion (angina) or a myocardial infarction is overweight, chest pains are likely to be more frequent, as the heart has to work harder. Therefore, weight reduction helps in relieving pain in patients with angina pectoris, and less medication is then required.
B. Heart Failure
In patients with heart failure, weight reduction is necessary because increased weight means more work for the heart. In heart failure patients the heart muscle is weak and the muscle is unable to pump sufficient blood from the heart into the circulation; blood remains in the lungs causing fluid to accumulate causing shortness of breath and edema of the legs occur (see the chapters Heart Failure and Heart Attacks).

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