In an adult with excess belly fat, what happens to systemic vascular resistance and cardiac workload?

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Central obesity increases the factors that constrict blood vessels and stiffen arteries, including vasoconstrictor substances, inflammatory mediators, and sympathetic activity. This raises systemic vascular resistance, meaning the left ventricle must generate higher pressure to eject blood. That higher afterload increases the heart’s workload and its oxygen demand. So the best choice describes both an increase in resistance and an accompanying increase in cardiac workload. The other possibilities don’t fit because decreased or unchanged resistance wouldn’t elevate afterload, and a higher resistance with reduced heart stress isn’t physiologically consistent.