AN OBESE PATIENT “PORTRAIT” BY THE RESULTS OF OUTPATIENT CARDIOVASCULAR REGISTRY “PROFILE”
https://doi.org/10.15829/1728-8800-2016-4-44-49
Abstract
Aim. To assess the opportunities for registry methodology for comparative evaluation of clinical and anamnestic characteristics of cardiological patients with and without obesity; to draw a “portrait” of the obese patients, common for the cohort studied.
Material and methods. The data analyzed from outpatient PROFILE registry during January 2011 to 31 august 2015: totally 1531 primary patient included, of those body mass index (BMI) collected in 1371. In 565 there was obesity of various grade, in 806 BMI was not higher than 30 kg/m2. The analysis done of retrospective data.
Results. According to PROFILE results, obesity was found in 41,2% of patients, and those with obesity were younger (p=0,003). Among them men and women number was equa — 50,8% and 49,2%, resp. For the obese there were characteristic presence of dyspnea, oedema and low level of physical activity (p=0,0001). The obese had 1,5-3 times more common arterial hypertension, 2 type diabetes, chronic heart failure (p=0,0001), glucose tolerance disordered (p=0,001), dyslipidemia (p=0,012). Regardless that the obese took medications more commonly (p=0,006), they more rarely reached target level of blood pressure (BP), than those non obese (p<0,05). Almost nobody of those with obesity had prescribed therapy against overweight, except 73 patients that participated in 2 clinical trials.
Conclusion. The data from outpatient registry PROFILE has confirmed the main information on obesity in cardiological patients: a “portrait” is drawn of the obese, cardiovascular risk factors (CRF) formulated, and comorbidities. The data demonstrates more difficult achievement of target BP in the obese with regular medication treatment, and highlights insufficient attention of physicians to diagnostics and especially treatment of obesity, as underestimation of the overweight problem by patients themselves.
About the Authors
A. V. ZakharovaRussian Federation
Yu. V. Lukina
Russian Federation
V. P. Voronina
Russian Federation
S. N. Tolpygina
Russian Federation
N. P. Kutishenko
Russian Federation
N. V. Kiseleva
Russian Federation
S. Yu. Martsevich
Russian Federation
Martsevich S. Yu. on behalf of “PROFILE” registry workgroup
References
1. Obesity and overweight. WHO Newsletter Updated June 2016. http://www.who.int/mediacentre/factsheets/fs311/en/
2. Whitlock G, Lewington S, Sherliker P, et al. Prospective Studies Collaboration. Body-mass index and cause-specific mortal-ity in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 2009; 373 (9669): 1083-96.
3. Apovian CM. Obesity: Definition, Comorbidities, Causes, and Burden. Am J Manag Care 2016; 22(S7): S176-85. Available at http://www.ajmc.com/journals/supplement/2016/Impact-Obesity-Interventions-Managed-Care/Obesity-Definition-Comorbidities-Causes-Burden/
4. Flegal KM, Kit BK, Orpana H, et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013; 309(1): 71-82.
5. Hubert HB, Feinleib M, McNamara PT, et al. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants of the Framingham Heart Study. Circulation 1983; 67: 968-77.
6. Calle EE, Thun MJ, Petrelli JM, et al. Body-mass index and mortality in prospective cohort of US adults. N Engl J Med 1999; 341: 1097-110.
7. Zakharova AV, Tolpygina SN, Voronina VP, et al. A comparative study of the efficacy and safety of the original and generic orlistat in obese patients in the PROFIL register. Rational Pharmacotherapy in Cardiology 2016; 12(1): 16-20. Russian (Захарова А. В., Толпыгина С. Н., Воронина В. П., Марцевич С. Ю. Сравнительное изучение эффективности и безопасности оригинального и воспроизведенного препаратов орлистата у пациентов с ожирением в рамках регистра ПРОФИЛЬ. Рациональная фармакотерапия в кардиологии 2016; 12(1): 16-20).
8. Lukina YV, Dmitrieva NA, Zakharova AV, et al. Adverse event of drug therapy (the first results of the study according to the PROFILE outpatient register). Rational Дмитриева Н. А., Захарова А. В. и др. Нежелательные явления лекарственной терапии (первые результаты исследования по данным амбулаторного регистра ПРОФИЛЬ). Рациональная фармакотерапия в кардиологии 2016; 12(3): 306-13).
9. Cardiovascular prevention. National guidelines of RSSC. Annex 2 to the journal "Cardiovascular therapy and prevention" 2011; 10(6): 31-8. Russian (Кардиоваскулярная профилактика. Национальные рекомендации ВНОК. Приложение 2 к журналу "Кардиоваскулярная терапия и профилактика" 2011; 10 (6): 31-8).
10. Mareev VY Ageev FT, Arutyunov GP, et al. National guidelines, SSHF, RCO and RNMOT for the diagnostics and treatment of chronic heart failure (4th ed). Journal of Heart Failure 2013; 14(7): 379-472. Russian (Мареев В. Ю., Агеев Ф. Т., Арутюнов Г. П. и др. Национальные рекомендации ОССН, РКО и РНМОТ по диагностике и лечению ХСН (четвертый пересмотр). Журнал Сердечная Недостаточность 2013; 14(7): 379-472).
11. Gress TW, Nieto FJ, Shahar E, et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. N Engl J Med 2000; 342(13): 905-12.
12. Melnichenko GA. Obesity in endocrinologist's practice. Russian Medical Journal 2001; 1: 82-92. Russian (Мельниченко Г. А. Ожирение в практике эндокринолога. РМЖ 2001; 1: 82-92).
13. Starostina EG. Treatment problems of patients with morbid obesity. Obesity and Metabolism 2011; 1: 35-41. Russian (Старостина Е. Г. Проблемы лечения пациентов с морбидным ожирением. Ожирение и метаболизм 2011; 1: 35-41).
14. Lavie CJ, Milani RV, Ventura H. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. JACC 2009; 53(21): 1925-32.
Review
For citations:
Zakharova A.V., Lukina Yu.V., Voronina V.P., Tolpygina S.N., Kutishenko N.P., Kiseleva N.V., Martsevich S.Yu. AN OBESE PATIENT “PORTRAIT” BY THE RESULTS OF OUTPATIENT CARDIOVASCULAR REGISTRY “PROFILE”. Cardiovascular Therapy and Prevention. 2016;15(4):44-49. (In Russ.) https://doi.org/10.15829/1728-8800-2016-4-44-49