[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.
Abstract

Related Concept Videos

Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
Obesity01:24

Obesity

The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in adipocytes...
Assessment of the Cardiovascular System I: Subjective Data01:23

Assessment of the Cardiovascular System I: Subjective Data

A thorough health history and physical assessment are essential for identifying cardiovascular disease (CVD) symptoms and distinguishing them from other health issues.
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution01:25

Pharmacokinetics in Obese Patients: Drug Absorption and Distribution

Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...