Achieving BMI <25 kg/m2 resulted in a 39.4% reduction in predicted ASCVD risk compared to a 10.6% reduction for those with BMI ≥25 kg/m2 (P < 0.001).
Does achieving a BMI <25 kg/m2 reduce predicted 10-year ASCVD risk in people with obesity or overweight?
Achieving a normal BMI (<25 kg/m2) with weight management interventions like tirzepatide is associated with a significantly greater reduction in predicted 10-year ASCVD risk compared to remaining overweight or obese.
Absolute Event Rate: 0% vs 0%
Summary: Background: Effective weight reduction interventions may significantly reduce obesity-related atherosclerotic cardiovascular disease (ASCVD) risk. However, evidence on the association between optimal body mass index (BMI) target and long-term ASCVD risk was limited. Methods: Pooled individual-level data from participants with obesity/overweight randomized to tirzepatide or placebo in SURMOUNT-1 (December 2019–April 2022; NCT04184622), -3 (March 2021–April 2023; NCT04657016), and -CN trials (September 2021–December 2022; NCT05024032) were analyzed. Ten-year ASCVD risk was calculated using the American College of Cardiology/American Heart Association Pooled Cohort Equations. A mixed model for repeated measures analysis was used to compare percent change in ASCVD risk from baseline by achieved BMI group (<25 kg/m2, ≥25 kg/m2) at trial end, with terms including achieved BMI group, time point, achieved-BMI-group-by-time-point interaction, and baseline covariates. Findings: Among 2691 participants included, 495 (18.4%) achieved BMI <25 kg/m2 at trial end. In addition to a significantly higher proportion being treated with tirzepatide (98.2% vs 66.8%), the BMI <25 kg/m2 group also had a higher proportion of females and lower mean BMI at baseline compared with the BMI ≥25 kg/m2 group (P < 0.001 for all). After adjusting for baseline covariates, relative to baseline, participants achieving BMI <25 kg/m2 had a significantly greater percent reduction in predicted ASCVD risk (39.4% vs 10.6%, P < 0.001) compared to the BMI ≥25 kg/m2 group. Among those with baseline intermediate-to-high ASCVD risk, reduction remained greater in the BMI <25 kg/m2 group (25.6%) than the BMI ≥25 kg/m2 group (9.0%; P < 0.001). Significantly greater improvements were also observed in blood pressure and lipids for the BMI <25 kg/m2 group (P < 0.001). Interpretation: Achieving BMI <25 kg/m2, primarily with tirzepatide, was associated with a significantly greater 10-year ASCVD risk reduction compared with those whose BMI remained at 25 kg/m2 or greater. These findings suggest potential cardiovascular benefits associated with targeting BMI <25 kg/m2 in the long-term weight management. Funding: This study was funded by Eli Lilly and Company.
Guo et al. (Sat,) reported a other. Achieving BMI <25 kg/m2 resulted in a 39.4% reduction in predicted ASCVD risk compared to a 10.6% reduction for those with BMI ≥25 kg/m2 (P < 0.001).