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Potential for optimizing management of obesity in the secondary prevention of coronary heart disease

2021; Oxford University Press; Volume: 8; Issue: 5 Linguagem: Inglês

10.1093/ehjqcco/qcab043

2058-5225

Dirk De Bacquer, Catriona Jennings, Erkin М Мirrakhimov, Dragan Lović, Jan Bruthans, Delphine De Smedt, Nina Gotcheva, M. N. Dolzhenko, Zlatko Fras, Nana Pogosova, Seppo Lehto, Hasan Hasan-Ali, Piotr Jankowski, Kornelia Kotseva, Guy De Backer, David Wood, Lars Rydén,

Cardiac Health and Mental Health

Prevention guidelines have identified the management of obese patients as an important priority to reduce the burden of incident and recurrent cardiovascular disease. Still, studies have demonstrated that over 80% of patients with coronary heart disease (CHD) fail to achieve their weight target. Here, we describe advice received and actions reported by overweight CHD patients since being discharged from hospital and how weight changes relate to their risk profile.Based on data from 10 507 CHD patients participating in the EUROASPIRE IV and V studies, we analysed weight changes from hospital admission to the time of a study visit ≥6 and <24 months later. At hospitalization, 34.9% were obese and another 46.0% were overweight. Obesity was more frequent in women and associated with more comorbidities. By the time of the study visit, 19.5% of obese patients had lost ≥5% of weight. However, in 16.4% weight had increased ≥5%. Weight gain in those overweight was associated with physical inactivity, non-adherence to dietary recommendations, smoking cessation, raised blood pressure, dyslipidaemia, dysglycaemia, and lower levels of quality of life. Less than half of obese patients was considering weight loss in the coming month.The management of obesity remains a challenge in the secondary prevention of CHD despite a beneficial effect of weight loss on risk factor prevalences and quality of life. Cardiac rehabilitation programmes should include weight loss interventions as a specific component and the incremental value of telehealth intervention as well as recently described pharmacological interventions need full consideration.