Weight Fluctuation Linked to Cardiovascular Events, Death

Maintaining a healthy weight is important for reducing disease risk and improving overall health. Findings from a study published in the New England Journal of Medicine suggest that weight fluctuation may increase the risk of stroke, heart attack, and mortality among patients with coronary artery disease.

This study was the first to determine how cycling between weight gain and weight loss can affect the health of patients with heart disease, according to the authors.

Patients were grouped by weight fluctuation: individuals in the high-fluctuation group had weight changes up to 8.6 pounds and individuals in the smaller-fluctuation group had weight changes under 2 pounds.

“Our findings suggest that we need to be concerned about weight fluctuation in this group that is already at high risk due to coronary disease,” said lead study author Sripal Bangalore, MD. “Even though this analysis was not designed to find out the causes of increased risk with body weight fluctuations, we need to examine how we can help Americans keep weight off, rather than having it go up and down.”

Included in the study were 9509 patients aged between 35 and 75 with pre-existing coronary artery disease, high cholesterol levels, and a history of cardiovascular problems. The authors reported that half of the patients were treated with high-dose cholesterol-lowering drugs.

The authors discovered that patients with large weight changes experienced 136% more strokes, 117% more heart attacks, and 124% more deaths compared with patients with smaller weight gains and losses, according to the study.

The authors cautioned that weight fluctuation was associated with statistically significant outcomes, which were observed among patients who were overweight or obese at baseline, and underscored the notion that preventing significant weight gain is beneficial. These findings were not found in normal weight patients.

Body weight fluctuation was also linked to new-onset diabetes, which is known to be associated with weight gain.

The authors found that the link between increased cardiovascular outcomes persisted, regardless of average weight and risk factors for heart disease, according to the study.

The authors note that they were unable to determine if patients intentionally lost weight, or if it resulted from an illness or other unintended reasons. These findings suggest that limiting or preventing weight gain can significantly reduce the risk of experiencing a stroke, heart, attack, or death.

The authors were also unable to discover whether heart problems were caused by weight fluctuation or other factors. Future studies should explore the link further, along with the potential reasons why weight fluctuation may lead to cardiovascular problems.

The authors hope that the findings will lead to additional research in these patients and lead to novel practice guidelines to improve care, according to the study.