Mildly Obese Fare Better after Major Heart Attack

Dr. Ian Neeland
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People who survive a major heart attack often do better in the years afterward if they're mildly obese, suggests new research published in the European Heart Journal: Quality of Care and Clinical Outcomes. In the three years after an attack, people considered mildly obese were 30 percent more likely to survive and spent fewer days in the hospital than those of normal weight, researchers found.

In the study by UT Southwestern Medical Center cardiologists, "mildly obese" was defined as having a body mass index (BMI) of 30 to 34.9 kg/m2, compared to normal weight, which is a BMI between 18.5 and 24.9. Patients of normal weight fared as poorly as those who were extremely obese, with a BMI of 40 or greater.

"I think the message from this finding is that if you've had a heart attack and you're overweight or mildly obese, you shouldn't necessarily try to lose weight aggressively in the initial period after the heart attack. The finding does not suggest that heart attack patients should try to gain weight if they are of normal weight," said cardiologist Dr. Ian Neeland, Assistant Professor of Internal Medicine and first author of the study.

The study expands a growing body of evidence showing that patients with some chronic illnesses who are mildly obese can have better outcomes compared with people of normal weight – a finding called the obesity paradox. One possible explanation for this is that mildly obese patients have more energy reserves to combat the illness, according to Dr. Neeland.

It's important to remember that adults who are obese or overweight are at greater risk of developing diabetes, high blood pressure, and high cholesterol in the first place, Dr. Neeland noted.

For this study, UT Southwestern researchers examined records from 19,499 Medicare patients (age 65 or older) discharged after a heart attack involving total artery blockage, then compared them with later treatment records to determine how the patients fared over the next three years. The mildly obese patients did better than all other groups, while those who were of normal weight or extremely obese fared the worst.

The findings suggest that factors other than BMI are likely more important in determining how a patient with heart disease will do, said Dr. James de Lemos, senior author of the study.

"Although obesity is clearly an important risk factor for the development of diabetes and heart disease, once a person already has heart disease, these relationships are not as clear cut," said Dr. de Lemos, Professor of Internal Medicine and holder of the Sweetheart Ball-Kern Wildenthal, MD, PhD, Distinguished Chair in Cardiology.

Source: UT Southwestern Medical Center
Image Credit: UT Southwestern

Published on : Tue, 4 Jul 2017


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heart attack, body mass index, mildly obese, total artery blockage People who survive a major heart attack often do better in the years afterward if they're mildly obese, suggests new research published in the European Heart Journal: Quality of Care and Clinical Outcomes

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