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欧洲冠心病超重及肥胖患者的管理

Management of overweight and obese patients with coronary heart disease across Europe.

作者信息

De Bacquer Dirk, Dallongeville Jean, Heidrich Jan, Kotseva Kornelia, Reiner Zeljko, Gaita Dan, Prugger Christophe, Wellmann Jürgen, Wood David, De Backer Guy, Keil Ulrich

机构信息

Department of Public Health, Ghent University, De Pintelaan 185 - Block A (2nd floor), B-9000 Gent, Belgium.

出版信息

Eur J Cardiovasc Prev Rehabil. 2010 Aug;17(4):447-54. doi: 10.1097/HJR.0b013e328336a05f.

DOI:10.1097/HJR.0b013e328336a05f
PMID:20485181
Abstract

AIMS

Several studies have reported increasing obesity rates in the general population. Using data from the EUROASPIRE III survey, we investigated as to what extent the obesity epidemic affects the high priority group of coronary heart disease patients.

METHODS AND RESULTS

Data from 8924 patients, who had experienced a recent coronary acute event, from 22 countries in Europe participating in the EUROASPIRE III study were gathered in 2006-2007. Eight centres had also participated in the earlier two EUROASPIRE surveys carried out in 1994-1995 and 1999-2000. In these eight centres, obesity prevalence in coronary patients had increased from 25 to 38% during the past decade. The most recent survey shows that obesity is more prevalent in women (45 vs. 32% in men) and is a major health problem across all the 22 countries. Only 18% of all the patients were found to reach a body mass index below 25 kg/m whereas 53% were diagnosed with central obesity. Since their hospital discharge, only half of the obese patients reported to have followed the dietary recommendations and 48% reported engagement in more physical activity. Only 13% of the patients who were overweight at the time of the coronary event reached the target of >or=5% weight loss whereas 21% of them presented with a weight gain of 5% or more.

CONCLUSION

The prevalence of obesity is still increasing and reaching epidemic proportions in the high priority group of coronary patients all over Europe. Patients' awareness and current management of obesity seems inadequate. More intensive programs focusing on diet and especially physical activity are urgently required.

摘要

目的

多项研究报告称普通人群肥胖率不断上升。利用欧洲动脉粥样硬化风险评估(EUROASPIRE)III调查的数据,我们研究了肥胖流行在多大程度上影响冠心病这一高风险人群。

方法与结果

2006 - 2007年收集了来自参与EUROASPIRE III研究的欧洲22个国家的8924例近期发生过冠状动脉急性事件患者的数据。8个中心还参与了1994 - 1995年和1999 - 2000年开展的前两次EUROASPIRE调查。在这8个中心,过去十年间冠心病患者的肥胖患病率从25%上升至38%。最近的调查显示,肥胖在女性中更为普遍(45%对男性的32%),并且是所有22个国家的主要健康问题。在所有患者中,仅18%的人体重指数低于25kg/m²,而53%被诊断为中心性肥胖。自出院以来,只有一半的肥胖患者报告遵循了饮食建议,48%报告增加了体育活动。在冠心病事件发生时超重的患者中,只有13%达到了体重减轻≥5%的目标,而其中21%体重增加了5%或更多。

结论

肥胖患病率仍在上升,在全欧洲冠心病这一高风险人群中已达到流行程度。患者对肥胖的认知及目前的管理似乎不足。迫切需要更强化的项目,重点关注饮食,尤其是体育活动。

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