Baseline Body Mass Index Status Research Articles

In-hospital outcomes of acute myocardial infarction patients without standard modifiable cardiovascular risk factors across varying body mass index

Abstract Background Individuals who present with acute myocardial infarction (AMI) in the absence of standard modifiable cardiovascular risk factors (i.e., SMuRF-less) seem to have a significantly increased risk of mortality; however, it remains unclear whether the ‘SMuRF paradox’ would be influenced by patients’ baseline body mass index (BMI) status. Purpose To assess the disparities in the prevalence and prognostic implications of SMuRF-less among patients with newly diagnosed AMI across varying body mass index (BMI). Methods Using data from the Improving Care for Cardiovascular Disease in China–Acute Coronary Syndrome (CCC–ACS) project, we retrospectively analyzed AMI patients with and without SMuRFs and categorized their baseline BMI as underweight (<18.5kg/m2), normal weight (18.5-24kg/m2), overweight (24-28kg/m2), and obese (>28kg/m2). The primary outcome was in-hospital all-cause mortality. Multivariable logistic regression models were used to estimate BMI-stratified associations between SMuRF-less and each outcome, sequentially adjusting for demographic, clinical characteristics, and prevention strategies. Results Between 2014 and 2019, 44,538 adult patients hospitalized for first-presentation AMI were included, of which 4,454 (10.0%) were SMuRF-less. The incidence of SMuRF-less declined from 16.2% to 6.5% as BMI increased by category, and it prevailed more frequently among females and elders regardless of their BMI status. During the median hospital stay of 9 days, SMuRF-less patients had a significant increase in in-hospital mortality than patients with one or more SMuRF (2.1% vs. 1.0%, adjusted odds ratio [OR], 1.750 [95% CI 1.057–2.896], P<0.001). The highest mortality rate was observed in the SMuRF-less underweight group (3.5%). Took ≥1 SMuRF and obese as the reference group as they presented the finest outcome, SMuRF-less underweight group exhibited the highest increase in mortality (3.5% vs 0.5%, adjusted odds ratio [OR], 3.854 [95% CI 2.130–6.973], P<0.001). However, interaction analyses provided no evidence that BMI significantly modifies SMuRF-less’s association with in-hospital mortality (P for interaction=0.247). Conclusion Approximately one-tenth of first-presentation AMI patients had no SMuRF, who were more frequently women, elders, and underweight. Compared with those with at least one SMuRF, SMuRF-less patients have a significantly higher risk of in-hospital mortality, especially in those underweight, while in-hospital survival was the most favorable among ≥1 SMuRF and obese patients.

Association between baseline body mass index and survival in men with metastatic hormone-sensitive prostate cancer: ECOG-ACRIN CHAARTED E3805.

E3805 (CHAARTED) is a phase 3 trial demonstrating improved survival for men with metastatic hormone-sensitive prostate cancer (mHSPC) randomized to treatment with docetaxel (D) and androgen-deprivation therapy (ADT) versusADT alone. We assessed the association of baseline body mass index (BMI) and metformin exposure with quality of life (QOL) and prostate cancer outcomes including survival in patients enrolled in the CHAARTED study. We performed a posthoc exploratory analysis of the CHAARTED trial of men with mHSPC randomized to treatment with ADT with or without D between 2006 and 2012. Cox proportional hazards models and Kruskal-Wallis test were used to evaluate the association between BMI with QOL and prostate cancer outcomes and between metformin exposure and survival. In 788 of 790 enrolled patients with prospectively recorded baseline BMI and metformin exposure status, lower BMI was not associated with survival, but was associated with high volume disease (p < 0.0001) and poorer baseline QOL on functional assessment of cancer therapy-prostate(p = 0.008). Only 68 patients had prevalent metformin exposure at baseline in the CHAARTED trial. Four groups were identified: ADT + D + metformin (n = 39); ADT + D (n = 357); ADT + metformin (n = 29); andADT alone (n = 363). Baseline clinicopathologic characteristics were similar between groups. In this small exploratory multivariable analysis, metformin exposure was not associated with survival (hazard ratio: 1.15; 95% confidence interval: 0.81-1.63, p = 0.44). There was no link between baseline BMI and survival, but lower baseline BMI was associated with features of greater cancer burden and poorer QOL.

Differential Benefit of Adjuvant Docetaxel-Based Chemotherapy in Patients With Early Breast Cancer According to Baseline Body Mass Index.

Lipophilic drugs, such as taxanes, have a high affinity for adipose tissue and a resulting higher volume of distribution. Here, we reanalyzed clinical trial data to investigate whether the efficacy of docetaxel-based chemotherapy differs from non-docetaxel-based chemotherapy in patients with breast cancer according to their baseline body mass index (BMI). We retrospectively analyzed data from all of the patients in the adjuvant BIG 2-98 trial (ClinicalTrials.gov identifier: NCT00174655; N = 2,887) comparing non-docetaxel- to docetaxel-containing chemotherapy. BMI (kg/m2) was categorized as follows: 18.5 to < 25, lean; 25 to < 30, overweight; and ≥ 30, obese. Disease-free survival (DFS) was the primary endpoint, and overall survival (OS) was the secondary endpoint. A second-order interaction was assessed among treatment, BMI, and estrogen receptor (ER) status. There was no difference in DFS or OS according to BMI in the non-docetaxel group, while reduced DFS and OS were observed with increasing BMI category in the docetaxel group. Adjusted hazard ratios for DFS and OS were, respectively, 1.12 (95% CI, 0.98 to 1.50; P = .21) and 1.27 (95% CI, 1.01 to 1.60; P = .04) for overweight versus lean groups and were 1.32 (95% CI, 1.08 to 1.62; P = .007) and 1.63 (95% CI, 1.27 to 2.09; P < .001), respectively, for obese versus lean groups. Similar results were obtained when considering ER-negative and ER-positive tumors separately and when considering only patients who received a relative dose intensity ≥ 85% for docetaxel. A joint modifying role of BMI and ER status on treatment effect was evident for DFS (adjusted P = .06) and OS (adjusted P = .04). This retrospective analysis of a large adjuvant trial highlights a differential response to docetaxel according to BMI, which calls for a body composition-based re-evaluation of the risk-benefit ratio of the use of taxanes in breast cancer. These results now must be confirmed in additional series.

Meal Habits, Body Fat Composition and Mood Status in Young Adults

Abstract Objectives To examine the association between meal habits (i.e., eating breakfast every day, usually ≥80% fullness at breakfast, and not eating snacks at night), body composition and the subsequent changes in mood status in young adults. Methods This is a longitudinal follow-up study based on a randomized trial (ClinicalTrials.gov Identifier: NCT03828812). Young adults were recruited based in a university campus in Taipei City, Taiwan. In total, 125 participants were recruited and 103 completed the follow-ups. Measured body composition (TANITA BC-418) and moods (Depression Anxiety Stress Scale, DASS) were assessed at baseline, the third month and 15th month from baseline. Baseline meal habits were based on the participants’ recall of their diets in the month before interview. We used mixed-effect model to test the association of baseline total body fat percentage and trunk body fat percentage and moods during follow-ups, adjusting for age, sex, baseline body mass index (BMI), food security status. Results After controlling for sex, age, BMI, and food security status at baseline, having breakfast every day at baseline was associated with 2.04 (se = 0.78, P = 0.0098) lower anxiety score and with 2.58 (se = 1.26, P = 0.0409) lower stress score at baseline. Meal habits were not associated with the subsequent changes in mood status. As for body composition, one % of trunk body fat replacing one % of non-trunk body fat at baseline was associated with 1.19 (se = 0.57, P = 0.0381) higher depression score, 1.02 (se = 0.47, P = 0.0327) higher anxiety score, 2.06 (se = 0.76, P = 0.0075) higher anxiety score at baseline. One % of non-trunk body fat percentage was associated with 2.60 (se = 1.02, P = 0.0116) lower anxiety score, as trunk body fat % is controlled. Baseline body fat composition parameters were not associated with the temporal changes in mood scores. The significance patterns were similar after adjusting for baseline physical activity level, assessed by International Physical Activity Questionnaire. Conclusions Breakfast habits and body composition, especially trunk body fat, was associated with university-based young adults’ emotional health status. Funding Sources Ministry of Science and Technology, Taiwan.

Dietary determinants of unhealthy metabolic phenotype in normal weight and overweight/obese adults: results of a prospective study

We aimed to investigate associations of dietary intakes with unhealthy metabolic phenotype development, in normal weight and overweight/obese adults separately. A total of 1114 individuals, aged ≥19 years, with healthy phenotype in the third examination cycle of Tehran Lipid and Glucose Study were followed until the fifth examination. Dietary intakes were estimated using the food frequency questionnaires, collected during the study. The participants were grouped as normal weight and overweight/obese according to the baseline body mass index (BMI). Unhealthy metabolic status was determined as having more than one component of metabolic syndrome using the Joint Interim Statement. Regardless of BMI, higher intakes of magnesium, dairy products, poultry, apples/pears, citrus fruits, and tea/coffee decreased the risk of developing unhealthy phenotype, while higher intakes of fast foods, organ meats, and potatoes increased the risk. Food intake can influence the transition to unhealthy phenotype in metabolically healthy adults, irrespective of the BMI status.

Near final adult height, and body mass index in overweight/obese and normal-weight children with idiopathic central precocious puberty and treated with gonadotropin-releasing hormone analogs.

Background The standard treatment of central precocious puberty (CPP) is gonadotropin-releasing hormone analogues (GnRHa). It is a concern that children treated with GnRHa are at risk of developing obesity which could impair the treatment outcomes. This study aimed to investigate the effect of GnRHa on body mass index (BMI) standard deviation score (SDS), and the influence of BMI status on treatment outcomes in children with idiopathic CPP (iCPP). Methods A retrospective cohort study in children with iCPP who completed GnRHa treatment and had attained near final adult height (NFAH) was conducted. Children with a history of disease or drug ingestion which could affect their BMI were excluded. BMI, BMI SDS, height (Ht), Ht SDS, predicted adult height (PAH), and NFAH were compared at baseline, 1 and 2 years during treatment, and at NFAH according to the baseline BMI status; normal weight and overweight/obesity. Results Fifty-eight children with iCPP treated with GnRHa were enrolled. The BMI SDS was significantly increased at 1 and 2 years during treatment in the overweight/obese group and at 1 year during treatment in the normal-weight group. However, at NFAH (2 years after treatment discontinuation), the BMI SDS was not statistically different from baseline in both groups. Ht gain, change in Ht SDS and BMI SDS were not statistically different from the baseline in both groups. Conclusions GnRHa results in a transient increase in BMI SDS during treatment and returned to baseline after treatment cessation. The benefit of GnRHa treatment on final Ht improvement is similar between overweight/obese and normal-weight patients.

The different effects of gonadotropin-releasing hormone agonist therapy on body mass index and growth between normal-weight and overweight girls with central precocious puberty

PurposeThe effects of gonadotropin-releasing hormone agonist (GnRHa) treatment on body mass index (BMI) are controversial in girls with central precocious puberty (CPP). We therefore evaluated auxological parameters during GnRHa therapy in patients with CPP, specifically focusing on changes in BMI.MethodsSeventy-seven girls with idiopathic CPP who underwent GnRHa therapy were retrospectively recruited. We investigated BMI changes during the treatment period after stratifying them according to baseline BMI status as follows: normal (BMI percentile of <85th) and overweight groups (BMI percentile of ≥85th).ResultsThe incidence of overweight/obesity (40.3%/23.4%) was very high in the girls with CPP. In the overall study population, no significant BMI change was observed during the GnRHa treatment period. However, when stratified according to baseline BMI status, the normal-weight group showed a significant increase in BMI-standard deviation score (SDS), whereas the overweight group showed no change in BMI-SDS. Baseline BMI-SDS was an independent predictor of changes in BMI during the GnRHa treatment period. Changes in weight-SDS were similar, but changes in height-SDS were significantly greater in the overweight group than in the normal-weight group, which explains the observed difference in BMI-SDS.ConclusionOur results demonstrate that the difference in the pattern of BMI changes among our CPP patients suggests that delayed puberty induced by GnRHa treatment may have different effects on linear growth according to baseline body composition. This study underscores the importance of individualized lifestyle intervention in CPP children.

Impact of baseline body mass index status on glucose lowering and weight change during sitagliptin treatment for type 2 diabetics

AimsThis study was designed to evaluate the efficacy of sitagliptin in Taiwanese diabetic subjects with different baseline BMI status. MethodsThis was a single-center, hospital-based, retrospective chart review in subjects (n=1874) with type 2 diabetes who received sitagliptin. Subjects were classified into subgroups depending upon their baseline BMI by Taiwan national weight classification: normal (BMI<24kg/m2) (n=504), overweight (BMI: 24–27kg/m2) (n=615), and obese (BMI⩾27kg/m2) (n=755). Changes in HbA1c and weight were evaluated over a 12month treatment period. ResultsFor all three groups, the HbA1c levels declined over the first three months by about 8%, and subsequently plateaued for the next nine months. Obese subjects were slower in reducing HbA1c compared with normal and overweight subjects (P<0.05), but at nine months the reduction was similar across groups. Mean body weight increased over the first nine months of sitagliptin therapy in subjects with normal BMI (57.12–58.30kg), but there was no change in mean body weight in the overweight group. After three months the obese groups had significantly greater loss in body weight compared with the normal group. ConclusionsBaseline BMI status may influence the reduction of HbA1c levels within the first six months of sitagliptin therapy and affect weight change after three months. Being obese was associated with an initial lag in HbA1c reduction and greater weight loss compared with normal and overweight subjects.

Differential outcome of the IDEFICS intervention in overweight versus non-overweight children: did we achieve 'primary' or 'secondary' prevention?

The aim of this study was to explore whether the IDEFICS intervention had a differential effect on 11,041 children's weight trajectories depending on their baseline body mass index status. Two subgroups of children are considered in the present analysis: those who were overweight or obese prior to the intervention and those who were neither overweight nor obese. Among children in all eight countries who did not have prevalent overweight or obesity (OWOB) at baseline, 2 years later, there was no significant difference between intervention and control groups in risk of having developed OWOB. However, we observed a strong regional heterogeneity, which could be attributed to the presence of one distinctly outlying country, Belgium, where the intervention group had increased risk for becoming overweight. In contrast, among the sample of children with prevalent OWOB at baseline, we observed a significantly greater probability of normalized weight status after 2 years. In other words, a protective effect against persistent OWOB was observed in children in intervention regions compared with controls, which corresponded to an adjusted odds ratio of 0.76 (95% confidence interval: 0.58, 0.98). This analysis thus provided evidence of a differential effect of the IDEFICS intervention, in which children with overweight may have benefited without having been specifically targeted. However, no overall primary preventive effect could be observed in children without initial overweight or obesity.

Unstable Body Mass Index and Progression to Probable Alzheimer's Disease Dementia in Patients with Amnestic Mild Cognitive Impairment.

We investigated the influence of body mass index (BMI) status at baseline and changes in BMI over a follow-up period on the development of dementia in amnestic mild cognitive impairment (aMCI) patients. The longitudinal data of 747 aMCI patients were used to investigate the relationships among baseline BMI status, subsequent changes in BMI (median follow-up duration: 1.6 years, interquartile range: 1.0-2.3 years), and risk of progression to probable Alzheimer's disease dementia (pADD). The aMCI patients were classified into underweight, normal weight, overweight, and obese subgroups, and further categorized into increased BMI, stable BMI, and decreased BMI subgroups during follow-up using a 4% mean annual change in BMI cut-off value. Compared to the normal weight group, the underweight group had a higher risk of pADD (hazard ratio [HR]: 1.89, 95% confidence interval [CI]: 1.07-3.37) while the obese group had a lower risk (HR: 0.70, 95% CI: 0.49-0.999). After controllingfor baseline BMI status, the decreased BMI (HR: 2.29, 95% CI: 1.41-3.72) and increased BMI (HR: 3.96, 95% CI: 2.62-6.00) groups were at increased risk of progression to pADD. Our findings suggested that underweight at baseline was associated with a higher risk of progression to pADD, while obesity at baseline predicted a lower risk. Furthermore, significant changes in BMI during the follow-up period reflected an increased risk of progression to pADD, regardless of BMI status at baseline.

Body mass change in Alzheimer's disease

A high body mass index (BMI) at mid-age or a decrease in BMI at late-age has been considered as a predictor for the development of Alzheimer's disease (AD). However, little is known about the BMI change close to or after AD onset. BMI of participants from three cohorts -the Washington Heights / Inwood Columbia Aging Project (WHICAP; population-based), the Predictors Study (clinic-based), and the National Alzheimer's Coordinating Center (NACC; clinic-based)- were analyzed longitudinally. We separately examined change of BMI before AD diagnosis in incident AD patients and after AD diagnosis in incident and prevalent AD patients. We used generalized estimating equations to test whether there were significant changes of BMI over time, adjusting for age, sex, education, race, and research center (for NACC study and Predictors study). Stratification analyses were run to determine whether the BMI changes depended on baseline BMI status (underweight or normal <25 kg/m 2, overweight ≥25-<30 kg/m 2, and obese ≥30 kg/m 2). BMI declined over time up to AD clinical onset, with an annual decrease of 0.21 (p=0.02) and 0.19 (p=0.03) kg/m 2(in WHICAP and NACC, respectively). Following the clinical onset of AD, there was no longer a significant decrease of BMI. BMI even increased (b=0.10, p=0.01) in prevalent AD participants of NACC study. During the prodromal period BMI decreased significantly over time only in obese participants of the NACC study (β= -0.82, p<0.0001). During the period shortly after diagnosis of AD, BMI increased in underweight/normal weight subjects (β= 0.31, p<0.0001) and BMI decreased in obese subjects (β= -0.40, p=0.05) in NACC. Among prevalent AD participants, BMI increased in underweight/normal weight in Predictors study (β= 0.21, p=0.06) and NACC (β= 0.21, p<0.0001), and decreased in underweight/normal weight participants in NACC (β= -0.26, p=0.001). No significant change was observed for overweight subjects in any of the three cohorts. Our study suggests that while BMI declines before AD incidence, decline levels off after clinical AD onset and it might even increase. The pattern of BMI change may also depend on the initial BMI.

Prediction of long-term metabolic effects of olanzapine and risperidone treatment from baseline body mass index in schizophrenia and bipolar disorder

Baseline body mass index (BMI), baseline BMI status (normal, overweight, obese) and early (1 month) BMI increases were tested as predictors of 6- and 12- month increases in glucose and lipid measures in 82 olanzapine (OLZ)- and 78 risperidone (RIS)-treated patients with schizophrenia, schizoaffective disorder, or bipolar disorder who participated in a 12-month randomized, prospective metabolic effects study. Baseline BMI predicted greater fasting glucose and HgbA1c levels at 12 months for both treatments. Early BMI change predicted fasting glucose levels at 6 months, but not HgbA1c or BMI, at either time point. For patients who received no concomitant mood stabilizers, early BMI change predicted 12 month HgbA1c values in the OLZ group, and 6- (but not 12-) month fasting glucose and HgbA1c values in the RIS group. Neither baseline BMI nor early BMI change consistently predicted increases in lipids with either drug. OLZ-treated patients with normal baseline BMI had greater increases in total cholesterol, triglycerides, and non-HDL-cholesterol than those who were overweight or obese. In conclusion, higher baseline BMI predicted adverse glycemic changes after 12 months with OLZ and RIS. Individuals with normal baseline BMI may be most susceptible to OLZ-induced hyperlipidosis. Frequency of metabolic screening should be independent of baseline BMI or rapid increases in BMI.

Increases in body mass index over a 7-year period and risk of cause-specific mortality in Korean men

The association between increased body mass index (BMI) and subsequent mortality remains unclear in Asians. This study investigated the associations between BMI increases and cause-specific mortality in middle-aged Korean men. We conducted a retrospective cohort study of 473 358 Korean men aged 30-64 years, who had undergone health examinations in both 1992 and 1998 and were followed up during 1998-2004. Cox proportional hazards for cause-specific 7-year mortality in relation to BMI changes after stratification of baseline BMI status were analysed. Mortality from cardiovascular disease (CVD) was associated with BMI in both 1992 and 1998. Non-CVD mortality was inversely associated with BMI in both 1992 and 1998. We cross-classified participants into groups based on their baseline BMI levels and percent BMI changes during follow-up; men with the lowest BMI level at baseline (BMI in 1992 <21 kg/m(2)) and stable BMI during follow-up (percent change in BMI <5%) were included in the reference category. Compared with the reference group, CVD mortality was higher in initially obese men (BMI in 1992 > or =25 kg/m(2)) with any increase of BMI, and in initially lean men (BMI in 1992 <21 kg/m(2)) or initially overweight men (BMI in 1992 23-24.9 kg/m(2)) with BMI increases of > or =10%. BMI increases of 5.0-9.9% in men with baseline BMI <25 kg/m(2) and stable BMI in men with baseline BMI > or =21 kg/m(2) appeared to lower the risk for non-CVD or all-cause mortality, to below the levels seen in the reference group. Among middle-aged Korean men, obesity or severe weight gain was detrimental to CVD mortality. An increase in BMI appeared to have a predictive value for CVD mortality, especially when used in combination with baseline BMI level. In contrast, moderate weight gain in non-obese men seemed to protect against non-CVD and all-cause mortality.

Multilevel analyses of effects of variation in body mass index on serum lipid concentrations in middle-aged Japanese men.

For the effective use of the annual workplace health checkup data, we tried to perform multilevel analyses to explore whether the year-to-year weight variation causes any concurrent effects on the lipid profiles among middle-aged Japanese workers. Subjects were 1939 healthy male workers 40-59 in age from whom serial data of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were collected during health checkups conducted in the years 1997-2000. The effects of body mass index (BMI) on serum concentrations of those lipids were investigated by statistical analysis with multilevel modeling to distinguish multiple levels of information with individual repeated measurements within individuals. A significant increase of TC and TG, and decrease of HDL-C with BMI increase were confirmed. Subanalyses according to both the baseline BMI status (< 25 kg/m2 or > or =25 kg/m2) and smoking status (never, former, or current) yielded the same BMI-dependent changes of lipid profiles, but obese never smokers failed to show significant effects of BMI on HDL-C concentrations. Multilevel analyses of annual health checkup data linked at individual levels indicated that year-to-year weight variation, though usually in a much narrower range than the between-individual variation, had a strong impact on the corresponding changes of serum concentrations of TC, HDL-C, and TG. This result supports the public health significance of intervention into weight control to prevent the development of atherogenic risks among a healthy workplace population.

Antihypertensive efficacy and tolerability of irbesartan/hydrochlorothiazide in hypertensive patients stratified by body mass index and type 2 diabetes mellitus status: A post hoc subgroup analysis of the Irbesartan/HCTZ Blood Pressure Reductions in Diverse Patient Populations trial

Objective: This was a post hoc subgroup analysis of efficacy and tolerability data from the Irbesartan/HCTZ Blood Pressure Reductions in Diverse Patient Populations (INCLUSIVE) trial stratified by baseline body mass index (BMI). The BMI subgroup data were also analyzed according to the presence or absence of type 2 diabetes mellitus (T2DM) at baseline. Methods: The 18-week, prospective, multicenter, open-label, single-arm INCLUSIVE trial evaluated the efficacy and tolerability of a fixed-dose combination of irbesartan/hydrochlorothiazide (HCTZ) in adult hypertensive patients with systolic blood pressure (SBP) that was uncontrolled after ≥4 weeks of monotherapy. Patients received placebo for 4 to 5 weeks, HCTZ 12.5 mg for 2 weeks, irbesartan/HCTZ 150/12.5 mg for 8 weeks, and irbesartan/HCTZ 300/25 mg for 8 weeks. Patients were stratified into BMI subgroups based on values at screening. Normal weight was defined as a BMI ≤24.9 kg/m 2, overweight as a BMI of 25 to 29.9 kg/m 2, and obesity as a BMI ≥30 kg/m 2. The primary efficacy end point was the mean change in SBP from baseline (end of the placebo phase) to week 18 in the overall intent-to-treat (ITT) population. Secondary efficacy end points were the mean changes in SBP and diastolic blood pressure (DBP) from baseline to week 18 in each BMI subgroup, the proportions of patients in each BMI subgroup achieving their SBP target (<140 mm Hg [<130 mm Hg for patients with T2DM]) and DBP target (<90 mm Hg [<80 mm Hg for patients with T2DM]), and the mean SBP and DBP responses at the end of each treatment period. Results: The ITT population included 736 patients, of whom 99 (13.5%) were normal weight, 243 (33.0%) were overweight, and 394 (53.5%) were obese. Mean baseline SBP and DBP values were similar across BMI subgroups. Obese patients were generally younger than normal-weight and overweight patients, and numerically more obese patients had T2DM and metabolic syndrome. The mean reductions in SBP and DBP at week 18 were statistically significant in all subgroups (all, P < 0.001); SBP and DBP goals were achieved by a respective 83.8% and 93.9% of normal-weight patients, 75.3% and 87.7% of overweight patients, and 76.9% and 77.2% of obese patients. Rates of SBP/DBP control to <140/90 mm Hg in normalweight, overweight, and obese patients without T2DM were 88.2%, 79.8%, and 80.9%, respectively; the corresponding rates of control to <130/80 mm Hg in patients with T2DM were 50.0%, 41.5%, and 38.5%. Conclusion: In this post hoc subgroup analysis of the INCLUSIVE trial, irbesartan/HCTZ combination therapy had comparable antihypertensive efficacy and tolerability regardless of BMI or diabetes status.

Impact of taxanes on weight gain during neoadjuvant chemotherapy (Ctx) for breast cancer (BC)

10606 Background: Weight gain after the diagnosis of BC has been associated with increased risk of recurrence and mortality. Previous studies have documented weight gain after cyclophosphamide, methotrexate, and 5-fluoruracil (CMF) and adriamycin and cyclophosphamide (AC) chemotherapy, but the impact of taxane chemotherapy has not been described. Methods: We reviewed the charts of 119 patients (pts) who completed neoadjuvant Ctx between 1997–2005. Age, baseline body mass index (BMI), tumor size, nodal status, hormone receptor status, menopausal status, co-morbid illnesses and anti-depressant use were collected. Weight was recorded at each Ctx visit and at follow-up visits for two years. Results: 22 pts received AC only. 97 pts received AC followed by a taxane - 58 docetaxel (D), 39 paclitaxel (P). Median f/u time was 26.3 months. 66/119 (55%) of pts gained weight during Ctx, with a median change of + 1 pound (range -28 to +19.5 pounds) at the end of Ctx. 49/119 (41%) of pts gained weight during AC and 76/97 (78%) of pts gained weight during the taxane. Mean weight change after AC was -1.8 pounds compared to +3.2 pounds after the taxane (p &lt; 0.001). Age, baseline BMI, and menopausal status prior to Ctx did not predict weight gain. There was no difference in weight gain between pts who received D vs. P (p = 0.19). 8/22 (36%) patients who received AC alone recurred, and 13/95 (14%) who received both AC and T recurred; however this was not statistically significant (p = 0.23). Total weight change during neoadjuvant Ctx did not predict recurrence; however weight gain during the AC portion was associated with a higher risk of recurrence when adjusted for weight gain during taxane Ctx (p = 0.035, Cox regression). Each one pound gained was associated with an 11% increase in risk of recurrence. Conclusions: Weight gain is common during neoadjuvant Ctx for BC, particulary during treatment with taxanes. Further follow up is required to establish if weight gain is maintained over time and to determine the impact of weight change on BC outcomes and health. No significant financial relationships to disclose.