News | Cardiac Diagnostics | April 25, 2017

Body Weight Fluctuations Linked to More Deaths in People with Coronary Artery Disease

Study finds group with largest weight changes experienced over 100 percent more strokes, heart attacks and deaths than those with smallest weight changes

Body Weight Fluctuations Linked to More Deaths in People with Coronary Artery Disease

April 25, 2017 — Repeated cycles of weight loss and gain may be linked to higher risk for stroke, heart attack and death in people with pre-existing coronary artery disease, according to a study published online in the New England Journal of Medicine.

Led by researchers at NYU Langone Medical Center, the study was the first to measure the effect of “weight cycling” on health outcomes in people with pre-existing heart disease. People with the largest weight changes were found to experience 136 percent more strokes, 117 percent more heart attacks and 124 percent more deaths than those with the smallest shifts in weight. Those in the high-fluctuation group had weight changes as large as 3.9 kilograms (or roughly 8.6 pounds), while weight varied by around 0.9 kilograms (just under 2 pounds) in the group with the smallest shifts in weight.

“Our findings suggest that we need to be concerned about weight fluctuation in this group that is already at high risk due to coronary disease,” said lead study author Sripal Bangalore, M.D., director of the cardiovascular outcomes group in the Cardiovascular Clinical Research Center at NYU Langone.

“Even though this analysis was not designed to find out the causes of increased risk with body weight fluctuations, we need to examine how we can help Americans keep weight off, rather than having it go up and down,” said Bangalore, an associate professor of medicine in the Leon H. Charney Division of Cardiology.

The research team reviewed data on 9,509 men and women with coronary artery disease who participated in the Treating to New Targets trial, which was originally concluded in 2005. Study participants were between the ages of 35 and 75. All had coronary artery disease, high cholesterol levels, and some history of heart problems. Half were being treated with cholesterol-lowering drugs in intensive (versus standard) doses to see if this resulted in fewer deaths. All were monitored for a median of 4.7 years. The analysis linked shifts in body weight to statistically significant differences in outcomes only in people who were overweight or obese at the beginning of the study, but not for people who started with normal weight. Body weight changes were also strongly linked to an increase in newly diagnosed diabetes, and associations persisted regardless of a person’s average body weight and traditional risk factors for heart disease.

The researchers caution that their re-analysis does not show a cause-and-effect relationship between weight cycling and poor outcomes, but only an association. The authors also recognize that they were unable to tell if people lost weight intentionally, unintentionally or due to illness, or if any eventual heart problems resulted directly from the weight loss, change in weight or illness.

Bangalore hopes that the current findings will lead to further study of weight fluctuation in people with coronary artery disease and to the development of related practice guidelines once all the evidence is in. In the United States, more than 36 percent of American adults are obese, according to the Centers for Disease Control and Prevention. Additionally, about half of Americans report they are trying to lose weight, and weight cycling is frequent. Obesity is known to increase the risk for high blood pressure, high cholesterol, and diabetes, as well as for coronary artery disease.

Besides Bangalore, other researchers involved in the study were Rana Fayyad and David DeMicco from Pfizer Inc.; Rachel Laskey from THOR Specialties; Frank Messerli at the University Hospital Bern, Switzerland; and David Waters at San Francisco General Hospital.

For more information: www.nejm.org

Related Content

U.S. Soldiers Have Worse Heart Health Than Civilians
News | Cardiac Diagnostics | June 06, 2019
Active duty Army personnel have worse cardiovascular health compared to people of similar ages in the civilian...
Late Dinner and No Breakfast Worsens Outcomes After Heart Attack
News | Cardiac Diagnostics | May 23, 2019
People who skip breakfast and eat dinner near bedtime have worse outcomes after a heart attack, according to research...
HRS Releases New Expert Consensus Statement on Arrhythmogenic Cardiomyopathy
News | Cardiac Diagnostics | May 14, 2019
The Heart Rhythm Society (HRS) released a first-of-its-kind consensus statement with guidance on the evaluation and...
New Best Practices Help Manage Heart Attack Patients Without Significant Signs
News | Cardiac Diagnostics | April 15, 2019
For the first time in the United States, doctors with the American Heart Association (AHA) have outlined best practices...
The most recent U.S. Food and Drug Administration (FDA) clearance was Siemens Healthineers high-sensitivity troponin I assays (TnIH) for the Atellica IM and ADVIA Centaur XP/XPT in vitro diagnostic analyzers. The test helps in the early diagnosis of myocardial infarctions without the need for serial tropic testing. The time to first results is 10 minutes.

The most recent U.S. Food and Drug Administration (FDA) clearance was Siemens Healthineers high-sensitivity troponin I assays (TnIH) for the Atellica IM and ADVIA Centaur XP/XPT in vitro diagnostic analyzers. The test helps in the early diagnosis of myocardial infarctions without the need for serial tropic testing. The time to first results is 10 minutes. 

Feature | Cardiac Diagnostics | March 22, 2019 | Linda C. Rogers, Ph.D.
Troponins are a family of proteins found in skeletal and heart (cardiac) muscle fibers that produce muscular contract
ACC/AHA Update Guidance for Preventing Heart Disease; Stroke
Feature | Cardiac Diagnostics | March 18, 2019
The choices we make every day can have a lasting effect on our heart and vascular health. Adopting a heart healthy...
AHA Statement Warns Hookah Smoking May Harm the Heart
News | Cardiac Diagnostics | March 08, 2019
Smoking tobacco in waterpipes, more commonly known as hookahs, results in inhaling toxic chemicals, often at levels...
PTSD Alone Does Not Increase Heart Disease Risk in Veterans
News | Cardiac Diagnostics | February 20, 2019
February 20, 2019 — Post-traumatic stress disorder (PTSD) by itself does not explain the...
Hormone Therapy May Increase Cardiovascular Risk During Gender Transition
News | Cardiac Diagnostics | February 18, 2019
Patients receiving hormone therapy as part of their gender-transition treatment had an elevated risk for cardiovascular...
Overlay Init