Introduction Apart from clinical events, health-related quality (HRQoL) is an important outcome in high-risk cardiovascular patients. As body mass index has been associated with clinical events (“obesity paradox”), we investigated the relationship between body mass index and health-related quality of life.
Methods Patients were included with hypercholesterolaemia and an indication for statin therapy in 1961 primary care practices. HRQoL was assessed with the Short Form (SF)-12 health status instrument at baseline, after 6 and after 12 months. Physicians assessed patient body mass index (BMI). A mixed-effects regression model accounting for the three measurement points was used to investigate (a) the association between BMI and HRQoL at baseline, and (b) the association between change in BMI and change in HRQoL.
Results A total of 5082 patients (2165 females) were included. The mean change in BMI within 12 months was 0.05 (SD: 1.11) kg/m2. At baseline, BMI was inversely associated with physical and mental SF-12 summary scores (β [95% CI]=−0.3 [−0.4 to −0.2], and −0.1[−0.1 to 0.0]). An increase in BMI of 1 kg/m2 within 12 months was associated with a significant decrease in physical but not mental SF-12 scores (0.3 [−0.4 to −0.1]). Due to an interaction with gender, the association between change in BMI and physical SF-12 scores was only prevalent in women (β=−0.5 [−0.7 to -0.2], p<0.001) but not in men (p=0.32).
Conclusion BMI is inversely associated with quality of life in high-risk cardiovascular patients. Increases in BMI may lead to a decrease in physical quality of life in women but not in men.
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