Sheng-Yong Dong1, Shuang-Tong Yan2, Man-Liu Wang3, Zhi-Bing Li2, Lian-Qing Fang4, Qiang Zeng5. 1. Healthcare Department, Agency for Offices Administration of PLA, Beijing, 100034, China. Electronic address: dsynh@126.com. 2. Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, 100853, China. 3. Peking University-Tsinghua University Joint Center for Life Sciences, Beijing, China, Advanced Academy of Interdisciplinary Sciences, Peking University, Beijing, 100871, China. 4. Healthcare Department, Agency for Offices Administration of PLA, Beijing, 100034, China. 5. Health Management Institute, Chinese PLA General Hospital, Beijing, 100853, China. Electronic address: zq301@126.com.
Abstract
BACKGROUND AND AIMS: It is recommended that patients with coronary heart disease (CHD) pursue a normal body weight, while the effects of body weight and weight change on prognosis are still controversial. The present study was to assess these effects using a large-scale population with CHD in China. METHODS: A total of 5276 patients with CHD were included from Jan 2000 to Dec 2014. Baseline and endpoint weights were measured. Outcomes including mortality and cardiovascular events were obtained. RESULTS: Relative to patients with normal weight, risks for adverse outcomes were lowest in overweight patients and similar in obese patients. Hazard ratios (HRs) and 95% confidence interval (95% CI) for all-cause death were 1.42 (1.06, 1.91) if overweight turned into normal weight and were 2.01 (1.28, 3.16) or 5.33 (2.81, 10.1) if obese turned into overweight or normal weight. Death risk increased with the extent of weight loss and moderate or large weight gain (p<0.05 for all). Similar results were found when risks for cardiovascular mortality and events were considered. Furthermore, these results remained significant when the patients were stratified by several covariates and even when several definitions of weight change were considered. CONCLUSIONS: Obesity did not increase adverse outcome risks in patients with CHD. Both weight loss and weight gain increased adverse outcome risks regardless of baseline body weight. The findings suggest that maintaining a stable weight may be a better strategy for the reduction of risks for cardiovascular outcomes and all-cause death in patients with CHD.
BACKGROUND AND AIMS: It is recommended that patients with coronary heart disease (CHD) pursue a normal body weight, while the effects of body weight and weight change on prognosis are still controversial. The present study was to assess these effects using a large-scale population with CHD in China. METHODS: A total of 5276 patients with CHD were included from Jan 2000 to Dec 2014. Baseline and endpoint weights were measured. Outcomes including mortality and cardiovascular events were obtained. RESULTS: Relative to patients with normal weight, risks for adverse outcomes were lowest in overweight patients and similar in obesepatients. Hazard ratios (HRs) and 95% confidence interval (95% CI) for all-cause death were 1.42 (1.06, 1.91) if overweight turned into normal weight and were 2.01 (1.28, 3.16) or 5.33 (2.81, 10.1) if obese turned into overweight or normal weight. Death risk increased with the extent of weight loss and moderate or large weight gain (p<0.05 for all). Similar results were found when risks for cardiovascular mortality and events were considered. Furthermore, these results remained significant when the patients were stratified by several covariates and even when several definitions of weight change were considered. CONCLUSIONS: Obesity did not increase adverse outcome risks in patients with CHD. Both weight loss and weight gain increased adverse outcome risks regardless of baseline body weight. The findings suggest that maintaining a stable weight may be a better strategy for the reduction of risks for cardiovascular outcomes and all-cause death in patients with CHD.
Authors: Angelo Campanella; Paolo Sorino; Caterina Bonfiglio; Antonella Mirizzi; Isabella Franco; Antonella Bianco; Giovanni Misciagna; Maria Gabriella Caruso; Anna Maria Cisternino; Maria Notarnicola; Valeria Tutino; Benedetta D'Attoma; Alberto Ruben Osella Journal: Int J Obes (Lond) Date: 2021-09-14 Impact factor: 5.095