Recognition, diagnosis and management of obesity after myocardial infarction

Lopez-Jimenez, F.; Malinski, M.; Gutt, M.; Sierra-Johnson, J.; Wady Aude, Y.; Rimawi, A.A.; Mego, P.A.; Thomas, R.J.; Allison, T.G.; Kirby, B.; Hughes-Borst, B.; Somers, V.K.
January 2005
International Journal of Obesity;Jan2005, Vol. 29 Issue 1, p137
Academic Journal
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.International Journal of Obesity (2005) 29, 137-141. doi:10.1038/sj.ijo.0802831 Published online 2 November 2004


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