Article Impact Level: HIGH Data Quality: STRONG Summary of Heart, heartjnl-2024-324383. https://doi.org/10.1136/heartjnl-2024-324383 Dr. Jufen Zhang et al.
Points
- This study analyzed 8,297 obese individuals with cardiovascular disease (CVD) from the UK Biobank to assess the impact of weight changes on cardiovascular outcomes over a median follow-up of 13.9 years.
- Participants were categorized into stable weight change (<5 kg), large weight loss (≥10 kg), and large weight gain (≥10 kg), with 52.7% maintaining stable weight, 14.2% experiencing large weight loss, and 5.1% having large weight gain.
- Large weight gain was significantly associated with higher cardiovascular death (HR: 3.05, 95% CI: 1.40–6.67) and all-cause mortality (HR: 1.93, 95% CI: 1.15–3.26) compared to stable weight.
- Large weight loss was not linked to a higher risk of cardiovascular or all-cause mortality, suggesting that maintaining or losing weight does not contribute to worsened outcomes.
- While the study identifies an association between weight gain and increased mortality risk, further research is required to understand the underlying mechanisms driving these outcomes in obese individuals with CVD.
Summary
This study, using data from the UK Biobank, investigates the impact of weight change on cardiovascular (CV) outcomes among obese individuals with established cardiovascular disease (CVD). A total of 8,297 participants with CVD and repeated weight measurements were included, with a mean age of 56.6 years, 43.1% of whom were female. The study assessed weight changes between baseline and follow-up, classifying them into stable weight change (weight loss or gain <5 kg), large weight loss (≥10 kg), and large weight gain (≥10 kg). The study’s median follow-up was 13.9 years (IQR: 13.1–14.6 years).
The analysis found that 52.7% of participants experienced stable weight change, 14.2% had large weight loss, and 5.1% had large weight gain. After adjusting for confounders, the study revealed that large weight gain was associated with significantly higher risks of cardiovascular (CV) death and all-cause mortality compared to stable weight. Specifically, large weight gain had a hazard ratio (HR) of 3.05 (95% CI: 1.40–6.67) for CV death and 1.93 (95% CI: 1.15–3.26) for all-cause mortality. On the other hand, large weight loss was not associated with increased risk for these outcomes.
These findings suggest that among obese individuals with CVD, significant weight gain is associated with a heightened risk of CV death and all-cause mortality. While the study establishes an important association, it also emphasizes the need for further research to explore the mechanisms linking weight changes with mortality in this population.
Link to the article: https://heart.bmj.com/content/early/2025/01/15/heartjnl-2024-324383
References Zhang, J., Schutte, R., & Pierscionek, B. (2025). Association of weight change with cardiovascular events and all-cause mortality in obese participants with cardiovascular disease: A prospective cohort study. Heart, heartjnl-2024-324383. https://doi.org/10.1136/heartjnl-2024-324383
