Intervention Review

Weight reduction for primary prevention of stroke in adults with overweight or obesity

  1. Cintia Curioni1,*,
  2. Charles André2,
  3. Renato Veras3

Editorial Group: Cochrane Metabolic and Endocrine Disorders Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 29 APR 2006

DOI: 10.1002/14651858.CD006062.pub2

Database Title

Additional Information

How to Cite

Curioni C, André C, Veras R. Weight reduction for primary prevention of stroke in adults with overweight or obesity. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD006062. DOI: 10.1002/14651858.CD006062.pub2.

Author Information

  1. 1

    Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Rio de Janeiro, Brazil

  2. 2

    Federal University of Rio de Janeiro, Neurology, Rio de Janeiro, Brazil

  3. 3

    State University of Rio de Janeiro, Institute of Social Medicine, Rio de Janeiro, Brazil

*Cintia Curioni, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier, 524 / 7º andar / bloco D - Maracanã, Rio de Janeiro, 20559-900, Brazil. c_curioni@uol.com.br.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Obesity is seen as a worldwide chronic disease with high prevalence that has been associated with increased morbidity from many conditions including stroke, which is the third leading cause of death in developed countries and a leading cause of severe long-term disability. The causal association between overweight or obesity and stroke is unclear and there is no definite study clarifying the role of obesity treatment in the prevention of a first stroke (primary prevention). Given the prevalence of stroke and the enormous health and economic cost of the disease, it is important to establish the possible impact of weight reduction per se on stroke incidence.

Objectives

To assess the effects of weight reduction in people with overweight or obesity on stroke incidence.

Search methods

MEDLINE, EMBASE, The Cochrane Library, LILACS, databases of ongoing trials and reference lists were used to identify relevant trials.

Selection criteria

Randomised controlled trials comparing any intervention for weight reduction (single or combined) with placebo or no intervention in overweight or obese people.

Data collection and analysis

No trials were found in the literature for inclusion in this review.

Main results

There are currently no results to be reported.

Authors' conclusions

Obesity seems to be associated with an increased risk of stroke and it has been suggested that weight loss may lead to a reduction of stroke occurrence. However, this hypothesis is not based on strong scientific evidence resulting from randomised controlled clinical trials. This systematic review identified the urgent need for well-designed, adequately-powered, multi centre randomised controlled trials assessing the effects of weight reduction in persons with overweight or obesity on stroke occurrence.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Weight reduction for primary prevention of stroke in adults with overweight or obesity

Rigorous scientific evidence linking overweight or obesity with increased risk for stroke is missing.

Overweight and obesity are important public health problems and are associated with many serious health conditions including stroke which is a leading cause of death and severe long-term disability. It appears logical that weight reduction in overweight or obese people should have positive health consequences lowering the number and consequences of strokes. Overweight is defined as a "body mass index" (BMI) between 25.0 and 29.9 kg/m2, if weight measured in kilogram is divided by height measured in meter, and obesity as a BMI equal or greater than 29.9 kg/m2.
Despite a thorough search of the available literature we were not able to identify any study of good quality investigating the relationship between weight reduction and the occurrence of strokes. If overweight or obese people want to reduce their risk profile by losing weight they need sound evidence for doing so since every intervention might have negative consequences as well, for example losing and regaining weight ("weight cycling") is associated with health hazards like cardiovascular diseases. There is an urgent need for adequate research (good randomised controlled clinical trials) hopefully providing better advice in the future.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

減重對於過重或肥胖成人中風的初級預防

肥胖是一種全球性高盛行率的慢性病.肥胖與許多併發症(包括中風)的增加相關,而中風是發展國家的第三位死因,也是嚴重長期失能的主因。過重或肥胖與中風的因果關係仍不清楚，且沒有明確的研究釐清肥胖治療對於第一次中風(初級預防primary prevention)的關聯。由於中風的高盛行率及其龐大的健康及經濟花費，確立減重是否會影響中風的發生率是很重要的議題。

目標

評估減重對於過重或肥胖者中風發生率的效果。

搜尋策略

我們從MEDLINE EMBASE、The Cochrane Library、 LILACS資料庫、正在進行的試驗、及參考文獻列表找尋相關的研究。最後的搜尋整理為2006年4月。

選擇標準

對於過重或肥胖者使用任何方式(單一或合併)減重相較於使用安慰組、或不接受任何減肥方式的隨機對照臨床試驗。

資料收集與分析

文獻上沒有發現任何試驗符合我們的選擇標準。

主要結論

目前沒有結論。

作者結論

肥胖似乎與增加中風的風險相關，且減重曾被建議可能減少中風的發生率。然而，這個假說沒有建立在強而有力、由隨機對照臨床試驗證實的科學證據上。這篇文章指出急迫需要設計良好、有力、及多中心隨機對照試驗來評估減重對於過重或肥胖成人發生中風的效果。

翻譯人

本摘要由臺灣大學附設醫院賴瑩純翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

缺乏嚴格的科學證據來串連過重或肥胖與中風風險增加的相關。過重與肥胖是重要的公衛問題，與許多嚴重健康問題(包括中風)有關聯，而中風又是死亡及長期失能的重要因素。邏輯上,減重應該可以改善過重或肥胖者的健康,減少中風的發生並改善其預後。過重的定義為身體質量指數body mass index�(BMI) 為25.0到29.9 kg/m2。即使徹底的搜尋可用的文獻，仍沒有找到好的研究在探討減重與中風發生的相關性。如果過重或肥胖的病人想要由減重來減少危險，他們會想知道相關證據，因為任何的方式減重都可能會有不良的結果，舉例來說反覆體重的減少與增加和健康危險(如心血管疾病)有關。我們急迫需要好的研究(設計良好、隨機對照臨床試驗)來提供好的建議。

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