Re: Relation of Body Mass Index to Outcome in Patients With Known or Suspected Coronary Artery Disease

MarilynMann wrote:
Galal et al., Relation of Body Mass Index to Outcome in Patients With
Known or Suspected Coronary Artery Disease

Am J Cardiology, Vol. 99, Issue 11, 6/1/07, 1485-90.

Increased body mass index (BMI), a parameter of total body fat
content, is associated with an increased mortality in the general
population. However, recent studies have shown a paradoxic relation
between BMI and mortality in specific patient populations. This study
investigated the association of BMI with long-term mortality in
patients with known or suspected coronary artery disease. In a
retrospective cohort study of 5,950 patients (mean age 61 ± 13 years;
67% men), BMI, cardiovascular risk markers (age, gender, hypertension,
diabetes, current smoking, angina pectoris, old myocardial infarction,
heart failure, hypercholesterolemia, and previous coronary
revascularization), and outcome were noted. The patient population was
categorized as underweight, normal, overweight, and obese based on BMI
according to the World Health Organization classification. Mean follow-
up time was 6 ± 2.6 years. Incidences of long-term mortality in
underweight, normal, overweight, and obese were 39%, 35%, 24%, and
20%, respectively. In a multivariate analysis model, the hazard ratio
(HR) for mortality in underweight patients was 2.4 (95% confidence
interval [CI] 1.7 to 3.7). Overweight and obese patients had a
significantly lower mortality than patients with a normal BMI (HR
0.65, 95% CI 0.6 to 0.7, for overweight; HR 0.61, 95% CI 0.5 to 0.7,
for obese patients). In conclusion, BMI is inversely related to long-
term mortality in patients with known or suspected coronary artery
disease. A lower BMI was an independent predictor of long-term
mortality, whereas an improved outcome was observed in overweight and
obese patients.


* * *

Does this mean patients with coronary artery disease should not be
told to lose weight?

This means that folks with coronary artery disease should be told to
lose the visceral adipose tissue (VAT) by eating less down to the
right amount rather than being told to lose weight by dieting.

May GOD bless you.

Prayerfully in Jesus' awesome love,

Andrew <><
--
Andrew B. Chung, MD/PhD
http://EmoryCardiology.com

"Unlike the 2PD-OMER Approach, weight loss diets can't be combined
with well-balanced diets."
http://HeartMDPhD.com/Love/TheTruth

.

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