Characteristics of overweight and obese patients undergoing a cardiac rehabilitation program

Introduction and Objectives Obesity is increasingly prevalent in our society and is associated with cardiovascular risk factors and the early development of cardiovascular disease. We aimed to analyze the characteristics and effects of cardiac rehabilitation programs based on BMI. Methods We evaluated 550 patients who completed a CR program from January 2022 to September 2024. Obesity was defined as a BMI > 30 and overweight between 25 and 30. The presence of risk factors, functional capacity using baseline and final exercise stress tests, quality of life using baseline and final SF-36 questionnaires, and laboratory profile during admission, after discharge, and at the end of the program were assessed. The chi-square test was applied to identify differences in qualitative variables and the Student t test for quantitative variables. Results The mean age of the patients was 58+/-9 years. Twenty-two percent were women, 55% had hypertension, 29% had diabetes, and 52% were smokers. The predominant pathology was acute coronary syndrome (90%), and 93% had coronary artery disease. Forty-eight percent were overweight, and 30% were obese. No differences were found in the prevalence of hypertension or smoking, but diabetes was more common in obese patients (36.6% vs. 26.5%, p=0.017). Initial functional capacity was lower (7.5 vs. 8.4 METs, p=0.002), and quality of life scores were similar. However, similar improvements in functional capacity and quality of life were observed across groups. Regarding the lipid profile, total cholesterol and LDL cholesterol levels during admission were higher, but the reduction in these levels was also greater (LDL cholesterol decreased by 40% vs. 32%, p=0.032), with similar total cholesterol and LDL cholesterol levels at the end of the program. In contrast, TG, remnant cholesterol, and TG/HDL levels during admission, after discharge, and after the program were higher. The presence of TG/HDL >2 at the end of stay was found in 36%, 48%, and 70% of patients with normal weight, overweight, and obesity (p=0.0000), and elevated remnant cholesterol levels at the end of stay were found in 9%, 14%, and 26% (p=0.017). Conclusions Obesity and overweight are present in the majority of patients undergoing cardiac rehabilitation. Despite having poorer functional capacity, they improve similarly to those with normal weight. Their laboratory profiles show atherogenic dyslipidemia and insulin resistance levels to a greater extent. Furthermore, the lipid profile cannot be completely normalized with the therapies currently used.FIGURE 1