[Cardiometabolic high risk patients with abdominal obesity. Frequency and risk factor profile in primary care]
Jürgen Scholze1, Wolfgang Lilienthal, Peter Bramlage
1Universitätsklinikum Charité, Campus Charite Mitte, Medizinische Poliklinik, Berlin. juergen.scholze@charite.de
Insights
Abdominal obesity is common and frequently co-occurs with type 2 diabetes and dyslipidemia. Current treatments often fail to reach target metabolic values, highlighting a significant gap in managing these cardiometabolic risk factors.
Area of Science:
- Cardiology
- Endocrinology
- Primary Care Medicine
Background:
- Abdominal obesity, measured by large abdominal girth, is linked to numerous cardiometabolic risks and poor outcomes.
- Understanding the prevalence of these risks in primary care is crucial for patient management.
Purpose of the Study:
- To determine the frequency of cardiometabolic risk factors (diabetes, dyslipidemia) in patients with abdominal obesity.
- To quantify the co-occurrence of these three risk factors.
- To assess the current medical care for these patients.
Main Methods:
- An open surveillance study design was employed.
- Physicians recorded comorbidities and medications for patients with abdominal obesity (waist circumference: men ≥102 cm, women ≥88 cm).
- Data were evaluated qualitatively and assessed exploratively.
Main Results:
- 53,147 patients with large abdominal girth were documented by 3,945 physicians.
- Type 2 diabetes mellitus was present in 71% of patients; dyslipidemia in 76%.
- All three risk factors (obesity, diabetes, dyslipidemia) occurred together in 35% of cases. Treatment targets were frequently unmet.
Conclusions:
- Abdominal obesity is a significant cardiovascular disease risk factor, often coexisting with type 2 diabetes, dyslipidemia, and hypertension.
- Conventional therapeutic strategies are often insufficient to achieve recommended metabolic targets.
- There is a need for improved management strategies for patients with combined cardiometabolic risks.
Objective:
A large abdominal girth is a measure for abdominal obesity that is associated with many cardiometabolic risk factors and ultimately with an unfavourable prognosis. In this context, the objective of this survey was, to document the frequency of concomitant cardiometabolic risk factors such as diabetes and dyslipidaemia in primary care, to quantify the cross-section of all three risk factors and to investigate the medical care situation of the patients.
Methods:
For the survey, an open surveillance study design was chosen. Privately practicing physicians of different specializations documented the comorbidities and the medications taken in patients with abdominal obesity (based on waist circumference [men > or = 102, women > or = 88 cm]). The data were evaluated qualitatively and assessed exploratively.
Results:
A total of 3,945 participating doctors documented 53,147 patients with large abdominal girth. In 71% of the cases, these patients also had type 2 diabetes mellitus. In 76% of the cases, the patients had dyslipidaemia and in 35% of the cases, all three risk factors occurred concomitantly. Taking multiple medications such as antihypertensives, antidiabetic and lipid-lowering agents and thrombocyte aggregation inhibitors, was common. However, the target values, for example, for blood sugar (HbA1c < 6.5 or < 7.0%) frequently could not be achieved with the conventional strategies.
Conclusion:
Abdominal obesity (based on abdominal girth) is an important risk factor for cardiovascular disease. It often occurs together with type 2 diabetes mellitus, (atherogenic) dyslipidaemia and arterial hypertension. Available therapeutic strategies are not always sufficient for achieving the recommended metabolic values.
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