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

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Abstract
Aims 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. Methods and results 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. Conclusions 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.
Keywords
Coronary heart disease, Obesity, Secondary prevention, QUALITY-OF-LIFE, CARDIAC REHABILITATION, ARTERY-DISEASE, WEIGHT-LOSS, CARDIOVASCULAR-DISEASE, EXERCISE CAPACITY, EUROPEAN-SOCIETY, OVERWEIGHT, RISK, MULTIDISCIPLINARY

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Citation

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MLA
De Bacquer, Dirk, et al. “Potential for Optimizing Management of Obesity in the Secondary Prevention of Coronary Heart Disease.” EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES, vol. 8, no. 5, 2022, pp. 568–76, doi:10.1093/ehjqcco/qcab043.
APA
De Bacquer, D., Jennings, C. S., Mirrakhimov, E., Lovic, D., Bruthans, J., De Smedt, D., … Rydén, L. (2022). Potential for optimizing management of obesity in the secondary prevention of coronary heart disease. EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES, 8(5), 568–576. https://doi.org/10.1093/ehjqcco/qcab043
Chicago author-date
De Bacquer, Dirk, Catriona S. Jennings, Erkin Mirrakhimov, Dragan Lovic, Jan Bruthans, Delphine De Smedt, Nina Gotcheva, et al. 2022. “Potential for Optimizing Management of Obesity in the Secondary Prevention of Coronary Heart Disease.” EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES 8 (5): 568–76. https://doi.org/10.1093/ehjqcco/qcab043.
Chicago author-date (all authors)
De Bacquer, Dirk, Catriona S. Jennings, Erkin Mirrakhimov, Dragan Lovic, Jan Bruthans, Delphine De Smedt, Nina Gotcheva, Maria Dolzhenko, Zlatko Fras, Nana Pogosova, Seppo Lehto, Hasan Hasan-Ali, Piotr Jankowski, Kornelia Kotseva, Gui De Backer, David Wood, and Lars Rydén. 2022. “Potential for Optimizing Management of Obesity in the Secondary Prevention of Coronary Heart Disease.” EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES 8 (5): 568–576. doi:10.1093/ehjqcco/qcab043.
Vancouver
1.
De Bacquer D, Jennings CS, Mirrakhimov E, Lovic D, Bruthans J, De Smedt D, et al. Potential for optimizing management of obesity in the secondary prevention of coronary heart disease. EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES. 2022;8(5):568–76.
IEEE
[1]
D. De Bacquer et al., “Potential for optimizing management of obesity in the secondary prevention of coronary heart disease,” EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES, vol. 8, no. 5, pp. 568–576, 2022.
@article{8717419,
  abstract     = {{Aims
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.

Methods and results
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.

Conclusions
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.}},
  author       = {{De Bacquer, Dirk and Jennings, Catriona S. and Mirrakhimov, Erkin and Lovic, Dragan and Bruthans, Jan and De Smedt, Delphine and Gotcheva, Nina and Dolzhenko, Maria and Fras, Zlatko and Pogosova, Nana and Lehto, Seppo and Hasan-Ali, Hasan and Jankowski, Piotr and Kotseva, Kornelia and De Backer, Gui and Wood, David and Rydén, Lars}},
  issn         = {{2058-5225}},
  journal      = {{EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES}},
  keywords     = {{Coronary heart disease,Obesity,Secondary prevention,QUALITY-OF-LIFE,CARDIAC REHABILITATION,ARTERY-DISEASE,WEIGHT-LOSS,CARDIOVASCULAR-DISEASE,EXERCISE CAPACITY,EUROPEAN-SOCIETY,OVERWEIGHT,RISK,MULTIDISCIPLINARY}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{568--576}},
  title        = {{Potential for optimizing management of obesity in the secondary prevention of coronary heart disease}},
  url          = {{http://doi.org/10.1093/ehjqcco/qcab043}},
  volume       = {{8}},
  year         = {{2022}},
}

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