Heart patients don't consider weight a CVD risk.(Clinical Rounds)

WASHINGTON -- Obese patients with coronary disease don't always see their excess weight as being part of the problem, Francisco Lopez-Jimenez, M.D., and his associates reported in a conference on cardiovascular disease epidemiology and prevention, sponsored by the American Heart Association.

A prospective survey of 229 patients who had recently been hospitalized for a coronary syndrome or revascularization revealed that, despite being aware of their excess weight, few of the patients actually perceived that their weight was related to their heart problems.

"Don't assume your patients understand this. You must make them aware of the implications of obesity with regard to heart disease, because how people perceive themselves drives their behavior," Dr. Lopez-Jimenez, of the Mayo Clinic and Mayo Foundation, Rochester, Minn., told this newspaper.

The patients had a mean age of 66 years and a mean body mass index of 30.5 kg/[m.sup.2]. Most were either overweight (45%) or obese (33%); 77% were male. On average, the patients perceived themselves as being 22 pounds overweight, which was fairly accurate.

"It was interesting ... people were more or less realistic in estimating how overweight they were," Dr. Lopez-Jimenez said.

The investigators looked for factors that were correlated with self-perception of risk for heart disease.

After adjustment for sex, comorbidities, socioeconomic status, and other potential confounders, only four factors--age, history of diabetes, and levels of readiness to change for weight loss and exercise--were significantly correlated with the patient's perceived risk for heart disease.