Abstract P344: Epidemiology and Burden of Patients Living With Overweight/Obesity and Established Atherosclerotic Cardiovascular Disease
Authors: Desai Jayashri , Zhao Zhenxiang , Michalak Wojciech , O Hartaigh Briain , Fabricatore Anthony , Faurby Mads , Swallow Elyse , Zhong Jia , Bi Shimin 
Published: May 2024

Introduction:
Obesity is a serious chronic, progressive metabolic disorder associated with increased morbidity and mortality. Compared with individuals of healthy weight, those living with overweight/obesity are at higher risk for atherosclerotic cardiovascular disease (ASCVD). Given the established relationship between obesity and ASCVD, individuals living with overweight/obesity and ASCVD may gain additional benefits by directly treating obesity.

Hypothesis:
We assessed the hypothesis that comorbidity burden is higher in adults living with overweight/obesity and ASCVD than in those without ASCVD.

Methods:
This was a retrospective real-world study using Optum Market Clarity, a linked electronic medical record and administrative health care claims data set. Adults living with overweight and ≥1 weight-related comorbidity or obesity were included. The point prevalence of ASCVD was described for the overall study period (1/1/2017 to 6/30/2021). Stratified prevalence analyses were conducted by age group (ie, ≤45 years, 45-64 years, and ≥65 years). Comorbidity burden was assessed as percentage of patients with weight-related comorbidities.

Results:
The study encompassed 4,773,152 patients eligible for prescription weight management treatment; 245,824 (5.3%) had been diagnosed with ASCVD. Over the study period of 2017-2021, with a median (Q1-Q3) follow-up time of 43.7 (29.0-57.2) months, peripheral arterial disease was the most prevalent (2.5%) ASCVD condition among these patients, followed by ischemic heart disease (2.2%) and ischemic or hemorrhagic stroke (1.3%). Yearly prevalence of peripheral arterial disease, ischemic heart disease, and ischemic or hemorrhagic stroke within the study period ranged from 2.3%-3.8%, 2.0%-3.2%, and 1.2%-1.8%, respectively. These patients, compared with those without ASCVD, had a mean age of 63.8 vs 49.4 years and mean BMI of 33.4 vs 34.7 kg/m
2
, and 52.7% vs 40.8% were male (all
P
<.001). The prevalence of ASCVD increased with age: patients aged ≥65 years had an overall prevalence of 14.1%, with yearly prevalence ranging from 13.3%-18.8%, compared with 5.5% in patients aged 45 to 64 years, with yearly prevalence ranging from 5.2%-7.8%. Overall, patients with ASCVD had a higher comorbidity burden than patients without ASCVD, including type 2 diabetes (49.7% vs 17.6%), prediabetes (15.5% vs 9.0%), dyslipidemia (75.6% vs 30.4%), obstructive sleep apnea (22.3% vs 10.2%), and chronic kidney disease (21.1% vs 3.7%; all
P
<.001).

Conclusions:
ASCVD is prevalent among people living with overweight/obesity, to a greater extent in older and male individuals. People living with ASCVD and overweight/obesity bear a substantially higher comorbidity burden compared with those without ASCVD. Further evidence is needed to support pharmacotherapy-based chronic weight management to lower the cardiovascular disease burden in this population.