Prevalence of obesity among adult patients with congenital heart disease: A population-based study

• DOI: 10.1016/j.ijcard.2025.133032
• Publication Date: 2025-02-14T17:48:13Z
• Authors: Mathilde S.K. Van...; Jani Thuraiaiyah; Troels H Joergensen; Anette Solis; Anne Langsted; Børge G. Nordestg...; Caroline Kistorp; Jakob Raunsoe; Søren S Schmiegelow; Mark Aplin; Morten Dahl; Chee Woon Lim; Annette S Jensen
• Keywords: BMI; ACHD; Atherosclerotic disease; Obesity

IntroductionAdults with congenital heart disease (ACHD) are at increased risk of premature atherosclerotic cardiovascular disease. Obesity is an independent risk factor for a number of cardiometabolic diseases including atherosclerotic cardiovascular disease in healthy individuals; however, data on obesity in ACHD are limited. This study examined the prevalence of obesity in ACHD and the possible correlation between obesity and ACHD lesion severity.MethodsFrom East Denmark, 7157 patients with ACHD were included and compared to 29,377 age- and sex-matched controls from the Copenhagen General Population Study.ResultsBased on measured height and weight, ACHD patients versus controls had reduced prevalence of overweight (33 % versus 41 %, p < 0.001). Obesity was equally prevalent between ACHD patients and controls (16 % versus 15 %, p = 0.08), while severe obesity was more prevalent in ACHD patients versus controls (2 % versus 1 %, p < 0.001). However, in ACHD patients aged 18–59 years, a higher prevalence of obesity and severe obesity combined was observed compared to controls (odds ratio: 1.17 [95 % CI: 1.07–1.28]). Only ACHD patients with mild lesions were more often obese or severely obese compared to controls.ConclusionsACHD patients and controls from the background population had a similar prevalence of obesity, however ACHD patients were obese at a relatively younger age. Across ACHD severities, only adult patients with mild congenital heart disease were more often obese. These findings highlight the necessity of early weight management in ACHD patients. Introduction: Adults with congenital heart disease (ACHD) are at increased risk of premature atherosclerotic cardiovascular disease. Obesity is an independent risk factor for a number of cardiometabolic diseases including atherosclerotic cardiovascular disease in healthy individuals; however, data on obesity in ACHD are limited. This study examined the prevalence of obesity in ACHD and the possible correlation between obesity and ACHD lesion severity. Methods: From East Denmark, 7157 patients with ACHD were included and compared to 29,377 age- and sex-matched controls from the Copenhagen General Population Study. Results: Based on measured height and weight, ACHD patients versus controls had reduced prevalence of overweight (33 % versus 41 %, p < 0.001). Obesity was equally prevalent between ACHD patients and controls (16 % versus 15 %, p = 0.08), while severe obesity was more prevalent in ACHD patients versus controls (2 % versus 1 %, p < 0.001). However, in ACHD patients aged 18–59 years, a higher prevalence of obesity and severe obesity combined was observed compared to controls (odds ratio: 1.17 [95 % CI: 1.07–1.28]). Only ACHD patients with mild lesions were more often obese or severely obese compared to controls. Conclusions: ACHD patients and controls from the background population had a similar prevalence of obesity, however ACHD patients were obese at a relatively younger age. Across ACHD severities, only adult patients with mild congenital heart disease were more often obese. These findings highlight the necessity of early weight management in ACHD patients.