Large Weight Swings Risky in CVD Patients With Obesity

TOPLINE:

Compared with stable weight, large weight gain (≥ 10 kg) is associated with an increased risk for cardiovascular death and all-cause mortality among individuals with obesity and cardiovascular disease. Large weight loss also is associated with an increased risk for all-cause mortality.

METHODOLOGY:

• Researchers conducted a prospective cohort study using data from the UK Biobank cohort (2006-2010) to examine the association between weight changes and the risk for cardiovascular death and all-cause mortality.
• Overall, 8297 participants with obesity (median age, 58 years; 43.1% women) who had cardiovascular disease (CVD) at baseline and repeated weight measurements were included in the analysis.
• CVD was defined as having a diagnosis of myocardial infarction, stroke, hypertension, or angina. Obesity was defined as having body mass index ≥ 30.
• Weight changes from baseline to the next follow-up visit were categorized as large weight loss/gain (≥ 10 kg), moderate weight loss/gain (5-10 kg), and stable weight (weight change between −5 and 5 kg).
• The primary outcomes were cardiovascular events, including a first cardiovascular hospitalization for cerebrovascular disease and ischemic heart disease, cardiovascular death, and all-cause mortality; the median duration of follow-up was 13.9 years.

TAKEAWAY:

• Large weight gain was linked to a higher risk for cardiovascular death (adjusted hazard ratio [aHR], 3.05; P P 
• Moderate weight gain was linked to an increased risk for ischemic heart disease (aHR, 1.48; P 
• Large weight loss was linked to an increased risk for all-cause mortality (aHR, 1.54; P 
• No significant association was observed between weight changes and the risk for cerebrovascular disease.

IN PRACTICE:

“Maintenance of a stable weight, although even in the obese range, is less likely to lead to death,” the authors of the study wrote. “Clarifying and understanding these associations can be of value on how to best manage the conditions in patients with both obesity and CVD and improve their quality of life,” they added.

SOURCE:

This study was led by Jufen Zhang, PhD, of the Clinical Trials Unit at the School of Medicine at Anglia Ruskin University in Chelmsford, United Kingdom. It was published online on January 16, 2025, in Heart.

LIMITATIONS:

The study did not provide information on whether weight changes were intentional or due to other reasons such as disease-associated cachexia, therapies, or cancer. The data on dietary intake were retrieved from questionnaires assuming stable dietary habits over time, which may have introduced bias. All the potential confounding factors were not accounted for, and the impact of weight changes could not be studied as the study lacked data on fitness.

DISCLOSURES:

The authors did not declare any specific grant for this research from any public, commercial, or not-for-profit funding agency. No competing interests were declared.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.