Abstract
Introduction: Obesity is linked to a number of metabolic conditions which are risk factors for cardiovascular disease. An increasing number of weight loss medications have become available as an adjunct treatment of obesity along with recommendations for diet and exercise. None have been shown to have effect on mortality or cardiovascular outcomes. Overweight and obesity are increasing and correlated with first but not necessarily recurrent cardiovascular events (CVE). This study assesses the safety and efficacy of weight loss as measured in the large prospective randomised weight loss trials for secondary prevention. Methods: PubMed search for trials measuring the specific effect of obesity reduction on cardiovascular events up to March 2019. Results:Tabled 1TrialLOOK-AHEADSCOUTCRESCENDOLIGHTCONVENECAMELLIASOSSLEEVE-PASSNumber5100107441869589108800120004047264OutcomeCVECVECVECVECVECVECVECV RiskHR0.95 p = 0.511.16 p = 0.020.97 p = 0.680.88n/a0.97 p = 0.550.76 p = 0.01n/aDuration10 yrs3.4 yrs13.8 mths2.9 yrs5 mths3.3 yrs15 yrs5 yrsStatusTerminatedWithdrawnTerminatedTerminatedTerminatedNo effect on CVEPrimary objective successful Secondary under-poweredWeight loss benefit shown with decrease in comorbidities. Open table in a new tab Conclusion: Deliberate weight loss in patients with baseline CVD do not prevent recurrent CVD and in fact may increase risk. Current guidelines need revision.
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