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Recognition, diagnosis and management of obesity after myocardial infarction

International Journal of Obesity volume 29, pages 137–141 (2005)Cite this article

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.

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Acknowledgements

Dr Lopez-Jimenez was supported in part by the Harry B Graf Career Development Award in Preventive Cardiology from the American College of Cardiology. Dr Somers was supported by National Institutes of Health Grants HL-65176, HL-61560, HL-70602, HL-73211, and M01-RR-00585.

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Authors and Affiliations

  1. Mayo Clinic and Mayo Foundation, Rochester, MN, USA

    F Lopez-Jimenez, J Sierra-Johnson, R J Thomas, T G Allison, B Kirby, B Hughes-Borst & V K Somers

  2. St Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA

    M Malinski

  3. University of Miami School of Medicine, Miami, FL, USA

    M Gutt

  4. University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Y Wady Aude, A A Rimawi & P A Mego

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  1. F Lopez-Jimenez
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  2. M Malinski
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  3. M Gutt
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  4. J Sierra-Johnson
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  9. T G Allison
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  11. B Hughes-Borst
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  12. V K Somers
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Correspondence to F Lopez-Jimenez.

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Lopez-Jimenez, F., Malinski, M., Gutt, M. et al. Recognition, diagnosis and management of obesity after myocardial infarction. Int J Obes 29, 137–141 (2005). https://doi.org/10.1038/sj.ijo.0802831

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