Factors Associated with Trying to Lose Weight in Women with Coronary Heart Disease: Do Factors Differ by Race/Ethnicity?

Abstract

Background: Guidelines in women with coronary heart disease (CHD) or myocardial infarction (MI) include achieving a healthy body mass index (BMI); however, after MI, weight loss on average is minimal. The aim of this research was to identify factors associated with trying to lose weight among white, non-Hispanic (NH), black, NH, and Hispanic/other women with a history of MI or CHD. Methods: This research used cross-sectional data (n=3,176) from five years of the Behavioral Risk Factor Surveillance System. Multivariable logistic regression models were stratified on race and variables were maintained in a full model to examine independent effects on trying to lose weight. Results: Mean BMI was 28.5 (standard deviation=6.8). More black, NH (76%) women reported overweight/ obese BMI compared to white, NH (62%), or Hispanic/other (64%, p<0.0001) women. With a BMI of overweight, 55% (confidence interval (CI): 49.1, 60.4) of white, NH, 50% (CI: 33.6, 66.0) of black, NH, and 59% (CI: 41.3, 76.7) of Hispanic/other women reported trying to lose weight (p=0.76). Overall, 57% reported no weight loss advice from a clinician. White, NH, black, NH, and Hispanic/other women who received weight loss advice were 5.0 (CI: 3.3, 7.4), 5.9 (2.3, 14.7), and 7.8 (CI: 3.5, 17.5) times more likely to report trying to lose weight compared to women without weight loss advice. Conclusions: The majority of overweight/obese women reported no clinician advice to lose weight. This is problematic as weight loss advice was the strongest predictor of trying to lose weight and weight loss is important to reducing risk for secondary event.