Effects of moderate weight loss on anginal symptoms and indices of coagulation and fibrinolysis in overweight patients with angina pectoris.
OBJECTIVE
To evaluate the effects of moderate weight loss, in overweight patients with angina, on plasma coagulation, fibrinolytic indicies and pain frequency.


METHODS
Single-stranded 12-week dietary intervention, an individualised eating plan with quantitative advice delivered by a dietitian. Target weight loss of 0.5 kg per week.


METHODS
Outpatient research clinic.


METHODS
Fifty-four volunteers with angina pectoris were recruited. Five subjects withdrew, so 27 males, 22 females, mean body mass index (BMI) 29.3 (s.d. 4.3) kg/m(2) and age 60.3 (s.d. 6.5) y completed the intervention.


METHODS
Body weight and frequency of anginal pain. Plasma fibrinogen, red cell aggregation (RCA), viscosity, factor VII activity, plasminogen activator inhibitor (PAI) activity, tissue plasminogen activator antigen (t-PA), plasma cholesterol, triglyceride and insulin.


RESULTS
After the 12-week dietary intervention period, mean body weight fell by 3.5 (s.d. 2.6) kg or 4.3% (P=0.0001), range -11.7 to +1.7 kg. Mean angina frequency fell by 1.8 (s.d. 3.6) from 3.2 to 1.4 episodes/week (P=0.009) and plasma cholesterol by 0.4 (s.d. 0.7) from 6.3 to 5.9 mmol/l (P=0.0001). HDL cholesterol and triglyceride were unchanged. Of the coagulation and fibrinolytic factors, factor VII activity and RCA were significantly reduced by 5 (s.d. 20), IU/dl (P=0.04) and 1.3 (s.d. 1.3) arbitrary units (P=0.014), respectively.


CONCLUSIONS
A conventional dietetic intervention, resulting in 4% weight loss, offers the potential to reduce atherosclerotic and thrombotic risk, and to reduce pain frequency, in angina patients. Given the importance of this result in a public health context, these results indicate that this may be a fruitful area for future nutrition research.
Hankey
C R
CR
Department of Human Nutrition, University of Glasgow, Glasgow, UK. c.r.hankey@clinmed.gla.ac.uk
Lean
M E J
ME
Lowe
G D O
GD
Rumley
A
A
Woodward
M
M
D000787:Angina Pectoris / Q000097:blood*; D001777:Blood Coagulation; D002784:Cholesterol / Q000097:blood; D004903:Erythrocyte Aggregation; D005167:Factor VII / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005342:Fibrinolysis; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D014280:Triglycerides / Q000097:blood / Q000378:metabolism; D015431:Weight Loss / Q000502:physiology*
D008055:Lipids; D017395:Plasminogen Activator Inhibitor 1; D014280:Triglycerides; D005167:Factor VII; D005340:Fibrinogen; D002784:Cholesterol