Re: Relation of Body Mass Index to Outcome in Patients With Known or Suspected Coronary Artery Disease
- From: MarilynMann <mannm@xxxxxxxxxxx>
- Date: Sat, 17 Nov 2007 11:56:01 -0800 (PST)
NEW YORK (Reuters Health) - The "obesity paradox" -- an unexpected
decrease in illness and death with increasing body weight or BMI,
which has been described in people with heart failure and in patients
having angioplasty -- exists in people with high blood pressure and
diseased heart arteries as well, new study findings show.
In the study, researchers found that overweight and obese adults with
high blood pressure and coronary artery disease had a lower risk of
heart attack, stroke or death, compared with their normal-weight
counterparts.
The reasons for the apparent protective effect of increased BMI in
these populations "are unclear," note Dr. Seth Uretsky from St. Luke's-
Roosevelt Hospital in New York City and colleagues in the American
Journal of Medicine.
They investigated the effect of overweight and obesity on heart-
related outcomes in 22,576 people with treated high blood pressure and
coronary artery disease who participated in a large study.
Compared to normal-weight subjects with a BMI between 20 and 25, the
risk of death, heart attack, or stroke was lower in subjects who were
overweight (BMI 25 to 30), and in those with class I obesity (BMI 30
to 35) and class II-III obesity (BMI 35 or greater).
"This 'obesity paradox' occurred in men and women across all age
groups, even though blood pressure was better controlled in normal-
weight patients," the investigators note.
In a commentary, Dr. Carl J. Lavie and colleagues of the Ochsner
Medical Center, New Orleans caution that while improved outcomes
appear to be consistently associated with increased BMI, "one should
not conclude that weight reduction is detrimental in overweight
populations."
Results of numerous studies, they point out, clearly support the
benefits of "purposeful weight reduction" in obese patients with heart
disease, despite the obesity paradox.
"As we continue to investigate the obesity paradox in cardiovascular
disease ... we should remember the old proverb, "Only one thing is
certain - that is nothing is certain," Lavie and colleagues advise.
SOURCE: American Journal of Medicine, October 2007.
.
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