Cardiovascular Consequences of Weight Gain
SOURCE: Bangalore S, et al. N Engl J Med 2017;376:1332-1340.
Obesity is recognized as an independent risk factor for numerous health consequences, including hypertension, cardiovascular events, cancer, and osteoarthritis. Whether progressive weight gain is associated with adverse outcome might be intuitively obvious, but has been less studied. The object of this report by Bangalore et al was to examine the association between weight variability and health outcomes, specifically addressing coronary heart disease.
The Treating to New Targets trial randomized patients with known coronary artery disease (n = 10,001) and a low-density lipoprotein reading of < 130 mg/dL to low-dose atorvastatin (10 mg/day) vs. high-dose (80 mg/day). In this post-hoc analysis, the authors examined the relationship between weight variability and subsequent coronary heart disease events over a mean five years’ treatment.
For every 1.5-1.9 kg increase in body weight from baseline, the risk of incurring a coronary event increased by 4%. The increase in body weight in persons who were normal weight at enrollment was associated with a numerically greater (but not statistically significant) number of coronary events. However, persons who were overweight or obese exhibited marked increases in coronary events proportional to the degree of their weight gain. Clinicians should be vigilant to offer patients with coronary disease advice about optimal weight management.
Clinicians should be vigilant to offer patients with coronary disease advice about optimal weight management.
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