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Welcome to the European Society of Cardiology. Our mission: to reduce the burden of cardiovascular disease in Europe
 

Being underweight increases death risk of CAD women by 2-fold 

Topics: Cardiovascular Disease Prevention - Risk Assessment and Management
Date: 03 Sep 2013
The aim of the study was to examine the effect of weight change over time on survival in women with CAD and different body weight classes. The study included 1,685 women (average age 64 years) diagnosed with CAD based on coronary angiography during 2005-2011. Body weight was obtained from anaesthesiology and coronary angiography records. Patients were followed for 6 years.


Amsterdam, The Netherlands – Tuesday 3 September 2013: Being underweight increases the death risk of women with coronary artery disease (CAD) by 2-fold, according to research presented at the ESC Congress today by Dr Aziza Azimi from Denmark. The study suggests that underweight women with CAD should gain weight to reduce their risk of death.

Dr Azimi said: “The increasing prevalence of obesity is concerning because it is a major risk factor for cardiovascular disease, early death and other diseases like diabetes mellitus type 2, high blood pressure, and high cholesterol. To our knowledge until now the impact of weight change on risk of death in women with CAD has not been studied.”

The aim of the current study was to examine the effect of weight change over time on survival in women with CAD and different body weight classes. The study included 1,685 women (average age 64 years) diagnosed with CAD based on coronary angiography during 2005-2011. Body weight was obtained from anaesthesiology and coronary angiography records. Patients were followed for 6 years.

Weight change was stratified into 3 groups: no change (gain or loss of <2 kg/year), weight loss (loss of >2 kg/year) and weight gain (gain of >2 kg/year). The women were also divided into four weight classes by body mass index (BMI, kg/m2): underweight (BMI<20 kg/m2), normal weight (BMI 20-24.9 kg/m2), overweight (BMI 25.0-29.9 kg/m2), and obese (BMI >30.0 kg/m2).

Hazard ratios (HRs) for risk of death were calculated using the normal weight group as reference. The researchers adjusted for age, smoking, diabetes, previous heart surgery, previous percutaneous coronary intervention, use of statins and antihypertensive drugs, and degree of CAD.

The researchers found that maintaining weight lowered the risk of death in obese women with CAD (HR=0.36, p=0.06 ). Weight gain and weight loss did not appear to affect their risk of CAD death compared to the normal weight group.
 
Dr Azimi said: “Weight maintenance decreased the risk of death in obese women with CAD. Obese women are more likely to be treated early with statins, antihypertensive or diabetes drugs, and this may reduce their risk. Weight management should be individual due to their medical condition.”

In contrast, underweight women who maintained their weight significantly increased their risk of death by 2-fold (HR=2.15, p=0.03). In this group, losing weight appeared to further increase their risk by 2-fold (although the findings were not significant).
 

Dr Azimi said: “Weight maintenance or weight loss seems to increase the risk of death in underweight women with CAD. Our findings suggest that these women should gain weight in order to reduce their risk of death.”

She concluded: “These data appear to be against the common sense that obesity is a risk factor for cardiovascular mortality as underweight has been even more strongly related to worse clinical outcome than overweight. Future investigations will be necessary to prove this new concept.”

Authors: ESC Press Office
For background information, please contact the ESC Press Office.
For independent comment on site, please contact the ESC Spokesperson coordinator.

Notes to editor

About the European Society of Cardiology
The European Society of Cardiology (ESC) represents more than 80 000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.

About ESC Congress 2013
The ESC Congress is currently the world’s premier conference on the science, management and prevention of cardiovascular disease.  The spotlight of this year's event is "The Heart Interacting with Systemic Organs".  ESC Congress 2013 takes place from 31 August to 4 September at the RAI centre in Amsterdam, Netherlands. More information on ESC Congress 2013 contact the ESC Press Office.

References

This press release accompanies both a presentation and an ESC press conference at the ESC Congress 2013. Edited by the ESC from material supplied by the investigators themselves, this press release does not necessarily reflect the opinion of the European Society of Cardiology. The content of the press release has been approved by the presenter.

More information on the ESC Press Conference page: Obesity: paradox or problem?