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Am J Med. 2014 Jul;127(7):641-649.e1. doi: 10.1016/j.amjmed.2014.02.032. Epub 2014 Mar 6.

Weight change in patients attempting to quit smoking post-myocardial infarction.

Author information

1
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, Lady Davis Institute for Medical Research of the Jewish General Hospital, Montreal, Quebec, Canada.
2
Division of Clinical Epidemiology, Lady Davis Institute for Medical Research of the Jewish General Hospital, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada.
3
Agence de la santé et des services sociaux, Direction de santé publique, Montreal, Quebec, Canada.
4
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada; Research Institute, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
5
CRCHUM and the Department of Social and Preventive Medicine, Université de Montreal, Montreal, Quebec, Canada.
6
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Research Institute, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
7
Multidisciplinary Cardiology Department, Institut universitaire de cardiologie et de pneumologie de Quebec (Quebec Heart and Lung Institute), Quebec City, Quebec, Canada.
8
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada; CRCHUM and the Department of Social and Preventive Medicine, Université de Montreal, Montreal, Quebec, Canada; Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
9
CHA Hôtel-Dieu de Lévis, Lévis, Quebec, Canada.
10
New Brunswick Heart Centre, Saint John, New Brunswick, Canada.
11
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, Lady Davis Institute for Medical Research of the Jewish General Hospital, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada. Electronic address: mark.eisenberg@mcgill.ca.

Abstract

BACKGROUND:

Current guidelines recommend smoking cessation and weight management for secondary prevention in patients post-myocardial infarction. However, little is known about the effects of smoking cessation on weight change post-myocardial infarction.

METHODS:

We examined patterns of weight change and its effects on blood pressure and glycemic control using data from a randomized trial investigating the effect of bupropion on smoking cessation in patients post-myocardial infarction. Weight change was compared among 3 groups of patients: those who were completely abstinent (n = 92), those who smoked intermittently (n = 49), and those who smoked persistently (n = 38) during the 12-month follow-up. Analyses were restricted to patients who attended all follow-up visits.

RESULTS:

The median weight at baseline was 77.1 kg (interquartile range [IQR], 66.0, 87.5), and 64.3% of patients were overweight/obese (body mass index ≥25.0 kg/m(2)). The median weight gain at 12 months was 4.0 kg (IQR, 0-7.0), with more than one third gaining >5 kg. The proportion of patients who were overweight/obese increased by approximately 10%, and 23.2% of patients moved up a body mass index category. Abstainers gained a median of 4.8 kg (IQR, 1.0, 8.6), intermittent smokers gained a median of 2.0 kg (IQR, -2.0, 5.0), and persistent smokers gained a median of 3.0 kg (IQR, -0.8, 6.0). Weight gain was associated with an increase in blood pressure and requirements for hypoglycemic medications at 12 months.

CONCLUSIONS:

The majority of patients attempting to quit smoking gain weight 12 months post-myocardial infarction, with abstainers gaining more weight than those who return to smoking. Weight gain was associated with an increased prevalence of hypertension and diabetes.

KEYWORDS:

Myocardial infarction; Randomized controlled trial; Smoking cessation; Weight change

PMID:
24608017
DOI:
10.1016/j.amjmed.2014.02.032
[Indexed for MEDLINE]
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