Psychosocial and Cardiometabolic Health of Patients With Differing Body Mass Index Completing Cardiac Rehabilitation

Abstract

BackgroundIt remains unclear whether cardiac rehabilitation (CR) provides similar benefits to patients with varying levels of body mass index (BMI). We assessed the psychosocial and cardiometabolic health of patients with increased BMI who completed CR. MethodsThe records of 582 patients who completed a 3-month outpatient CR program were analyzed. On the basis of their BMI at baseline, patients were categorized as normal (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), obese (30.0-34.9 kg/m2), or severely obese (≥ 35.0 kg/m2). Analysis of covariance was used to compare health-related quality of life (ie, Physical Component Summary [PCS] and Mental Component Summary scores), anxiety, depression, and cardiometabolic health indicators between BMI categories after CR. ResultsAt baseline, patients with severe obesity, when compared with those with normal BMI, had lower PCS scores (39.7 ± 8.5 vs 44.4 ± 8.4, P < 0.001), elevated levels of anxiety (7.0 ± 3.7 vs 4.8 ± 3.2, P = 0.001) and depression (5.5 ± 4.4 vs 3.4 ± 3.7, P < 0.001), higher glycated hemoglobin A1C (6.5 ± 1.1 vs 5.6 ± 0.7%, P < 0.001) and triglycerides (1.6 ± 0.5 vs 1.1 ± 0.4 mmol/L, P < 0.001), and lower high-density lipoprotein cholesterol (1.1 ± 0.3 vs 1.2 ± 0.4 mmol/L, P = 0.006). After CR, notwithstanding a greater percent weight reduction in obesity (−3.5% ± 6.9% vs +1.1% ± 7.0%, P = 0.002) and severe obesity (−6.5% ± 6.9% vs +1.1% ± 7.0%, P < 0.001), smaller improvements in PCS scores were seen in the obese (4.1 ± 7.4 vs 6.9 ± 7.6, P = 0.011) and severely obese (4.1 ± 7.6 vs 6.9 ± 7.6, P = 0.039) when compared with those with normal BMI. ConclusionsPoorer psychosocial and cardiometabolic health at baseline coupled with smaller improvements in the PCS score suggest that patients with obesity and severe obesity will benefit from enhanced care in the CR setting.