Recognition, diagnosis and management of obesity after myocardial infarction

F. Lopez-Jimenez, M. Malinski, M. Gutt, J. Sierra-Johnson, Y. Wady Aude, A. A. Rimawi, P. A. Mego, R. J. Thomas, T. G. Allison, B. Kirby, B. Hughes-Borst, V. K. Somers

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

OBJECTIVE: We investigated the documentation of obesity as a medical problem, and subsequent management recommendations, in patients after myocardial infarction (MI). DESIGN: We performed a cross-sectional analysis of a randomly selected sample of 627 patients discharged after an MI, from five US teaching hospitals between 1/1/01 and 12/31/02. Information was extracted from clinical notes using standardized definitions. RESULTS: Mean body mass index (BMI) was 31 ± 13 kg/m2, which was documented in only 14% of patients and had to be calculated post hoc in the rest. Waist circumference and waist/hip ratio were not documented at all; 83% of patients were overweight, 55% obese, and 8% morbidly obese. In only 20% of patients with BMI ≥ 30 kg/m2 was the diagnosis of obesity documented either as a current medical problem, as part of past medical history or as a final diagnosis. A dietary counseling was carried out in 61% of patients with BMI ≥ 25 kg/m2 and in 61% of patients with BMI < 25 kg/m2, P = 0.96. Weight loss was described as part of the goals/plan at discharge in 7% of overweight and 9% of obese patients. There was no change in either the level of recognition of obesity (22 vs 19%, P = 0.3) or in the proportion of obese patients for whom weight loss was described as part of the goals/plan at discharge (8 vs 10%, P = 0.7) before (n = 301) compared to after (n = 326) the Call to Action in Obesity by the Surgeon General in December 2001. CONCLUSION: Obesity is underecognized, underdiagnosed and undertreated in persons with acute MI.

Original languageEnglish (US)
Pages (from-to)137-141
Number of pages5
JournalInternational Journal of Obesity
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2005

Keywords

  • Awareness
  • Diagnosis
  • Myocardial infarction
  • Risk factor

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health
  • Endocrinology
  • Food Science
  • Endocrinology, Diabetes and Metabolism

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