**8. Conclusions**

In conclusion, obesity patients have an important difference than patients with normal weight. First, the chronic inflammation is the principal cause of molecular and cellular changes that have been linked to development of chronic diseases and manifestations due to decreased expansibility of adipose tissue. Endothelial dysfunction is an important factor that contributes to vascular calcification and atherosclerosis. In addition, the intestinal microbiota plays an important role in the development and inflammation of atherosclerotic plaque. Obesity is linked to major risk of CVD and is directly proportional to the amount of excess weight, it can be explained by blood pressure, cholesterol, and glucose levels. Diagnosis must be evaluated according to the risk and the clinical probability of suffering an event, evaluating the expected

changes at the electrocardiographic level that can lead to overdiagnosis. Finally, remember that there are currently multiple noninvasive studies for the early diagnosis of cardiovascular disease, which have allowed more timely diagnoses to be made in obese patients.
