Obesity management remains challenge in CHD prevention in women, younger individuals
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Despite weight-loss benefits for secondary CHD prevention, obesity management remains prevalent and challenging, especially among women and younger individuals, according to study findings.
“The European Surveys of Cardiovascular Disease Prevention and Diabetes (EUROASPIRE) revealed very high prevalence of both obesity and central obesity, which have further increased during the past 2 decades to an alarming level,” Dirk De Bacquer, MD, professor of epidemiology, research methodology and biostatistics in the department of public health and primary care at Ghent University, Belgium, and colleagues wrote in European Heart Journal – Quality of Care and Clinical Outcomes. “Comprehensive evidence on the management of obese patients with CHD in daily clinical practice is welcome to further understand this epidemic in order to develop more effective preventive strategies.”
Researchers analyzed changes in weight from hospital admission to the time of a study visit between 6 and 24 months later in 10,507 patients with CHD (mean age, 63 years; 25% women) who participated in the EUROASPIRE IV and V studies. The EUROASPIRE studies were a series of large, cross-sectional surveys in patients with CHD to generate objective assessments of implementing the European guidelines on CVD prevention in clinical practice through patients describing their management through lifestyle modifications and drug therapy use.
In the cohort, 34.9% of patients had obesity and 46% had overweight at hospitalization. Obesity was associated with more comorbidities: 25% of patients with overweight and 37.2% with obesity had diabetes; 74.7% with overweight and 85.2% with obesity had hypertension; 66.1% with overweight and 69.9% with obesity had dyslipidemia; and 4.4% with overweight and 6.2% with obesity had HF before hospital admission.
Obesity was more frequent in women than in men, the researchers wrote.
Weight loss of at least 5% occurred in 19.5% of patients with obesity (20.7% men and 16.6% women) and weight loss of at least 10% among 7.5% of patients with obesity (8.1% men and 6.2% women) by the time of the study visit. However, 16.4% of patients with obesity experienced a weight increase of more than 5%.
Among patients with overweight or obesity, weight gain was associated with physical inactivity, nonadherence to dietary recommendations, smoking cessation, raised BP, dyslipidemia, dysglycemia and lower levels of quality of life (P < .0001 for all).
In addition, 50% of patients with obesity had not attempted weight loss in the past month, 42% were considering weight loss in the coming month and 60% were considering weight loss in the next 6 months.
“Cardiovascular prevention and rehabilitation programs should include weight-loss intervention, including different forms of self-support, as a specific component of a comprehensive intervention to reduce total cardiovascular risk, extend life expectancy and improve quality of life,” De Bacquer and colleagues wrote.
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