I hope you have had a good week. Mine has been another super-busy one, with another conference in London. This week was the British Society for Heart Failure annual meeting. Rather than a video this week, I thought I would write so as to get some of the statistics I learnt down in black and white. My first observation from the conference however was just how badly I sleep these days after spicy food and a couple of glasses of wine! I’m only 45, yet felt much older as I tossed and turned at night feeling my heart beating a bit too fast and a touch of indigestion! The curry for dinner was so delicious, it was on balance worth it though!
My main take-away (pun intended) was in one key area.
• Obesity and heart failure
In the UK, obesity rates are now the highest in Europe, with almost three quarters of people aged 45-74 in England overweight or obese. The rates have increased faster than in most other countries. (Source – NHS Digital).
Complications in people with a body mass index (BMI) >30 are common: 3% risk of stroke; 3.5% risk of heart failure; 8% risk of ischaemic heart disease; 21% risk of heart attack; 51% risk of high blood pressure.
When we look at dilated cardiomyopathy (big hearts which don’t work well), it appears the age at which a person becomes overweight is also important, with adolescents at hugely increased risk. The risk increases sharply after the BMI gets above about 25 in this younger age group. At a BMI of 30, a person is about 6x more likely to develop heart failure!
Interestingly, in diabetic patients, increasing weight, whilst it is associated with worsening sugar control, does not hugely increase the risk of heart attacks. It does hugely increase the risk of heart failure however, largely of the ‘preserved ejection fraction’ type. You can read more about this in other parts of the members section on my website.
This all seems rather doom and gloom doesn’t it?! Well there is room for optimism in data presented at the conference. Firstly, a study from Sweden showed over the last 20 years, the incidence of coronary heart disease has reduced by over half! Stroke and heart attacks have reduced by nearly half, and heart failure by a quarter. Healthy populations can dramatically reduce their risk!
I expect many of you reading this have become members because you are motivated either by your own health or that of loved ones. Could you use these numbers as motivation to make a lifestyle change for the better? I can prove it will pay dividends –
A trial published in 2016 showed a 7kg weight loss to equate to a 7 point improvement in a validated wellbeing score. I don’t have the space here to go into the scoring system in detail, but trust me, 7 points is BIG.
A recent trial of semagultide (you may have heart about this as the wonder weight loss drug, and I should definitely do a blog on this soon) in heart failure patients showed a 10.7% weight loss, 7.8 point improvement in the same wellbeing scale, and improvement in other blood bio-markers of heart failure and inflammation.
The benefits of sustained weight loss occur EARLY too. Within days to weeks, fat in the liver is reduced, blood glucose improves, triglycerides improve, and blood pressure lowers. Within months, the heart can remodel (actually change structure for the better). The improvement in risk of heart attacks and strokes admittedly takes longer, with the process being measured in years, but what a good reason to continue to maintain a normal weight, or reduce further if needed! (I am definitely a glass half full person).
I hope this has inspired you, it certainly inspired me to get the message out there, and encourage as many people as possible to pursue the benefits of weight loss. I am also a pragmatist though. People need the odd treat, life would be dull without them! This included my curry at the conference, which I am sure was FULL of ghee and butter (before I get accused of being a hypocrite!), but I did do an hour in the hotel gym beforehand. Not perfect by any means, but I keep plugging away.
Best Wishes
Chris
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