Cardiovascular effects of weight reduction in obese patients with angina pectoris.

Reduction in body weight to normal limits by dietary restriction over a period of one year did not result in any symptomatic, electrocardiographic, or haemodynamic improvement in 6 obese patients with exercise-induced angina pectoris.Over the same period there was no symptomatic or objective evidence of cardiac deterioration in 4 similar patients who failed to reduce weight.Weight reduction is frequently advised in obese patients with ischaemic heart disease, particularly those suffering from exercise-induced angina pectoris.Whatever the assumptions on which such advice is based, there is little objective information available of the effects of weight reduction on the symptoms or electrocardiographic signs of myocardial ischaemia or on the abnormal function of the heart in these patients.Furthermore, there are reports that suggest that starvation may exert deleterious effects on the heart both in healthy subjects (Garnett et al., I969; Sandhofer et al., I973) and in patients with pre-existing heart disease (Cubberley, Polster, and Schulman, I965; Spencer, I968).For these reasons the following