Background: Body mass index (BMI) reduction in secondary prevention of cardiovascular diseases requires a multidimensional intervention.
Aims: We aimed to evaluate the effect of regular 1-year nursing supervision on weight reduction in secondary prevention in patients with acute coronary syndromes.
Methods: The study was conducted from 2018 to 2022. Seven thousand six hundred twelve patients were enrolled within 12 months after acute coronary syndrome, and regular nursing counseling was conducted every 2 months.
Results: A 5% reduction in BMI was achieved by 6812 (89.75%) patients. BMI of the entire population decreased (27.47[0.08] vs. 27.19 [0.08]; P <0.001). The BMI reduction was achieved in all patients regardless of their sex, smoking status, and level of education measured by the International Standard Classification of Education (ISCED) as well as in the subgroup with the highest stress level, 26.95(0.2) vs. 27.11 (0.06); P = 0.03, and the lowest physical activity level 27.63 (0.06) vs. 27.31 (0.06); P = 0.01. Linear regression showed that active smoking status (β -0.77; 95% confidence interval [CI], -0.95 to -0.59; P <0.001), ISCED 5-8 (β -0.43; 95% CI, -0.82 to -0.03; P = 0.03), ISCED 2 (β 0.79; 95% CI, 0.05-1.53; P = 0.04), ISCED 3 (β 0.55; 95% CI, 0.16-0.93; P = 0.01), the level of triglycerides (β 0.78; 95% CI, 0.61-0.95; P <0.001), and the waist-hip ratio (β 0.74; 95% CI, 0.68-0.80; P <0.001) were the strongest predictors of BMI change.
Conclusions: After 1 year and 6 follow-up visits, the average BMI of the entire population decreased significantly. BMI decreased in men and women, smokers and non-smokers, in patients with all levels of education, and in the subgroups with high stress and low physical activity. The strongest predictors of BMI reduction were high educational status and active smoking status.
Keywords: acute coronary syndrome; body mass index; nursing counseling; public health management; secondary prevention.