In response to research, the therapy of weight problems in coronary heart sufferers wants extra consideration
At the time of hospitalization, 34.9% of the patients were obese and 46.0% were overweight. Approximately 16 months after hospitalization, 86% of patients who were obese during the hospital stay were still obese, and 14% of overweight patients continued to gain weight until they reached the standard for obesity, which is a BMI of 30 kg / m was defined. m2 or more; Overweight was defined as a BMI of 25 to 30 kg / m2.
Women under the age of 55 were particularly affected, almost half of whom were overweight and participated in the study.
Notably, the authors found that weight gain was significantly linked to smoking cessation, something encouraged by all patients, but especially those with heart disease. If patients were overweight or obese during their hospital stay and then quit smoking, they gained an average of 1.8 kg, compared with an average gain of 0.4 kg during the hospital stay for those who continued to smoke.
However, the study authors found that more than a third of overweight patients said they had not received any advice on physical activity or diet to lose weight, and almost 1 in 5 even said they were overweight.
“It appears that obesity is not viewed by doctors as a serious medical problem that requires attention, recommendations, and obvious advice on personal weight goals,” the authors said.
The research team pooled data from the studies EUROASPIRE IV (2012 to 2013) and EUROASPIRE V (2016 to 2017), which were carried out in 29 countries. The 10,507 patients were visited 6 to 24 months after their hospital stay for their cardiac event (e.g. heart attack or elective surgery to unblock blocked arteries). The visit consisted of an interview, questionnaire and clinical examination including weight, height and blood tests. Researchers assessed patient actions, advice received, and the relationship between weight changes and health status.
In relation to this association, patients who were overweight or obese and who had lost 5% or more of their body weight since hospitalization had significantly lower levels of hypertension, lipid metabolism, and previously undiagnosed diabetes compared to patients who had 5% or more of their body weight increased. The former group had an increased consumption of fruits, vegetables and fish as well as a higher intake of reduced fat and sugar. They also participated in a cardiac rehabilitation and prevention program and reported a higher physical and emotional quality of life.
While more than a third of obese patients reported not receiving weight loss advice, less than two thirds recommended following dietary recommendations (63.7%) or exercising regularly (64.2%). Half of all patients, regardless of their weight status, received the same recommendation to follow a cardiological prevention and rehabilitation program.
Weight loss is strongly recommended in overweight or obese patients with coronary artery disease to reduce the chance of another cardiac event.
“Acceptance and access to cardiac rehabilitation programs are poor, with less than half of patients across Europe saying they have completed a program,” said study author Catriona Jennings, professor at the National University of Ireland – Galway. “Such programs would be a good opportunity to help patients fight overweight and obesity, especially female patients who were identified as having the greatest overweight and obesity problem in the study.”
De Bacquer D, Jennings CS, Mirrakhimov E, et al. Potential to optimize obesity management in secondary prevention of coronary artery disease. Eur Heart J Qual Care Clin Results. 2021. doi: 10.1093 / ehjqcco / qcab043.