Overweight and obesity are major risk factors for cardiovascular disease (CVD) and meaningful weight loss is associated with a reduction in CVD risk. Yet patients’ efforts at weight reduction often are frustratingly futile. In this issue of Heart , Tijssen and colleagues1 evaluated weight change from baseline to 12-month follow-up in the subgroup of overweight patients (BMI ≥27 kg/m2) with coronary artery disease in the Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists-2 (RESPONSE-2) multicentre randomised trial. The 280 patients in the intervention arm were offered community-based programmes to achieve weight reduction, increase physical activity and stop smoking in addition usual care, which included cardiology visits, cardiac rehabilitation and counselling on secondary prevention. Although there was wide variation in weight loss for patients in both the intervention and usual care groups, participation in a weight loss programme was associated with weight loss of ≥5% (OR 3.33 compared with usual care) (figure 1). Other factors associated with meaningful weight loss were older age, lower educational level, not smoking and motivation to start weight loss at the baseline visit. Figure 1 Waterfall plots; weight change from baseline to …

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心跳：心血管疾病患者的减肥干预措施

超重和肥胖是心血管疾病 (CVD) 的主要危险因素，有意义的体重减轻与 CVD 风险的降低有关。然而，患者为减轻体重所做的努力往往令人沮丧地徒劳无功。在本期《心脏》中，Tijssen 及其同事 1 在门诊护士专家二级预防的随机评估中评估了患有冠状动脉疾病的超重患者亚组（BMI ≥27 kg/m2）从基线到 12 个月随访的体重变化-2 (RESPONSE-2) 多中心随机试验。干预组的 280 名患者接受了以社区为基础的计划，以实现减轻体重、增加体育锻炼和戒烟以及常规护理，包括心脏病就诊、心脏康复和二级预防咨询。尽管干预组和常规护理组患者的体重减轻差异很大，但参与减肥计划与体重减轻 ≥ 5% 相关（与常规护理相比，OR 3.33）（图 1）。与有意义的减肥相关的其他因素包括年龄较大、教育水平较低、不吸烟以及在基线访问时开始减肥的动机。图 1 瀑布图；体重从基线变化到……