Abstract 14298: Sex Differences in the Association Between Obesity and Quality of Life in Patients With Coronary Artery Disease
Introduction: The impact of obesity on hard medical outcomes in those with coronary artery disease (CAD) is yet to be sufficiently understood. However, there is even less of an understanding of the quality of life (QOL) of obese patients suffering from CAD, or the role that sex plays in modifying that relationship.
Methods: This study included subjects who underwent coronary angiography in Alberta between 2002 and 2010 and completed self-reported questionnaires including the Seattle Angina Questionnaire (SAQ) and the EuroQol 5D (EQ-5D index). Patients were grouped into 5 body mass index (BMI) categories. Baseline characteristics were compared across BMI categories, as were SAQ and EQ-5D index scores. Additionally, linear regression models adjusted for age, sex, all available clinical and demographic covariates and depression were constructed.
Results: A total of 15191 subjects were included in the study. Subjects in higher BMI categories were younger and had a higher prevalence of hypertension and diabetes (all p<0.0001). SAQ scores in dimensions of angina severity or frequency did not differ significantly across BMI categories. In contrast, SAQ physical limitation (PL) and quality of life (QOL) scores were progressively diminished in increasing BMI categories relative to normal BMI. The same was seen for EQ-5D scores (all p-values <0.05). In adjusted models, BMI was no longer associated with SAQ-QOL (p>0.05), but it remained associated with SAQ-PL and EQ-5D index scores (p<0.05). Comparisons by sex revealed that women had lower mean scores for all dimensions of the SAQ and EQ-5D index across BMI categories. In sex-stratified models, the associations between obesity and SAQ and EQ-5D index differed by sex, with steeper declines in SAQ-PL and EQ-5D with increasing BMI seen in women versus men.
Conclusions: In comparison to those of normal weight, subjects who were overweight or obese had a diminished SAQ-PL and EQ-5D index. The extent of decline in these measures as obesity increased was greater in women. These findings underline that cardiovascular disease and its risk factors manifest differently in women vs. men. The findings also show that the diminished functional status associated with obesity is primarily in domains of physical limitation and mobility.
- © 2011 by American Heart Association, Inc.