Medicina · 2025
Breaking the weight of therapeutic inertia: obesity management in cardiology practice.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Garagoli Fernando, Bluro Ignacio, Fiorini Norberto, Slipczuk Leandro, Barolo Ramiro, Izaguirre Andrés, Fernández Recalde María Luz, Cuello Karen, Iglesias Diego, Pizarro Rodolfo
Аннотация
INTRODUCTION: Obesity is a major risk factor for cardiovascular diseases. While cardiologists play a key role in managing these patients, the extent of their involvement in obesity-related diagnosis and treatment remains unclear. This study aimed to assess the practices and approaches of cardiologists in Argentina regarding obesity management.
MATERIALS AND METHODS: We conducted a cross-sectional survey using a web-based questionnaire. The survey was distributed via WhatsApp employing convenience and snowball sampling among cardiologists practicing in Argentina.
RESULTS: Of the 380 questionnaires sent, we received 363 responses. A total of 130 cardiologists (35.8%) were unaware of the normal body mass index (BMI) range. Most respondents did not routinely assess weight (n = 293; 80.7%) or waist circumference (n = 330; 90.9%), and only 101 (27.8%) consistently calculated BMI. Regarding lifestyle interventions, 218 cardiologists (60.1%) always recommended a healthy diet, and 306 (84.3%) always promoted physical activity. Pharmacological treatment had never been prescribed by 207 respondents (57.0%), and 237 (65.3%) had never recommended metabolic surgery. Glucagon-like peptide-1 receptor agonists were the most frequently administered treatment, reported by 123 cardiologists (78.9% of those who prescribed pharmacological treatment). In multivariate analysis, >10 years of experience was significantly associated with prescribing pharmacological treatment (OR: 2.51; 95% CI: 1.52-4.17) and referring patients for metabolic surgery (OR: 2.37; 95% CI: 1.41-3.96). Practicing in the private sector was associated with the prescription of pharmacological treatment (OR: 2.97; 95% CI: 1.04-8.49), whereas male cardiologists demonstrated a greater propensity for referring patients for metabolic surgery (OR: 1.72; 95% CI: 1.02-2.92).
DISCUSSION: This study highlights the need for improvements in cardiologists' training and promotion of proactive behaviors in obesity management, as significant gaps in knowledge, diagnosis, and therapeutic interventions were identified.
MATERIALS AND METHODS: We conducted a cross-sectional survey using a web-based questionnaire. The survey was distributed via WhatsApp employing convenience and snowball sampling among cardiologists practicing in Argentina.
RESULTS: Of the 380 questionnaires sent, we received 363 responses. A total of 130 cardiologists (35.8%) were unaware of the normal body mass index (BMI) range. Most respondents did not routinely assess weight (n = 293; 80.7%) or waist circumference (n = 330; 90.9%), and only 101 (27.8%) consistently calculated BMI. Regarding lifestyle interventions, 218 cardiologists (60.1%) always recommended a healthy diet, and 306 (84.3%) always promoted physical activity. Pharmacological treatment had never been prescribed by 207 respondents (57.0%), and 237 (65.3%) had never recommended metabolic surgery. Glucagon-like peptide-1 receptor agonists were the most frequently administered treatment, reported by 123 cardiologists (78.9% of those who prescribed pharmacological treatment). In multivariate analysis, >10 years of experience was significantly associated with prescribing pharmacological treatment (OR: 2.51; 95% CI: 1.52-4.17) and referring patients for metabolic surgery (OR: 2.37; 95% CI: 1.41-3.96). Practicing in the private sector was associated with the prescription of pharmacological treatment (OR: 2.97; 95% CI: 1.04-8.49), whereas male cardiologists demonstrated a greater propensity for referring patients for metabolic surgery (OR: 1.72; 95% CI: 1.02-2.92).
DISCUSSION: This study highlights the need for improvements in cardiologists' training and promotion of proactive behaviors in obesity management, as significant gaps in knowledge, diagnosis, and therapeutic interventions were identified.