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Background <p>Obesity and overweight are major risk factors for cardiovascular diseases. Although various weight control interventions have been evaluated individually, their comparative effectiveness across outcomes and populations remains uncertain.</p> Objectives <p>To evaluate the effects of weight control interventions on all-cause mortality and cardiovascular outcomes.</p> Methods <p>A comprehensive search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library from inception to June 2024. Meta-analyses reporting pooled effect sizes for all-cause mortality or cardiovascular outcomes were included. Reviews without quantitative synthesis were excluded. Risk of bias and methodological quality were assessed using A Measurement Tool to Assess Systematic Reviews and the Grading of Recommendations Assessment, Development and Evaluation approach. No new meta-analysis was conducted, relevant data were re-analyzed when required to ensure consistency. This review was registered in PROSPERO (CRD42024573542).</p> Results <p>Forty-seven effect sizes from 31 articles were extracted. Among pharmacologic interventions, high- to moderate-quality evidence showed that glucagon-like peptide-1 receptor agonists (GLP1-RAs) were associated with reduced all-cause mortality, major adverse cardiovascular events, stroke, cardiovascular mortality, myocardial infarction, and heart failure among individuals with type 2 diabetes or overweight/obesity. Bariatric surgery was consistently associated with reduced risks for all cardiovascular outcomes except atrial fibrillation. For dietary strategies, low-fat diets were linked to lower all-cause mortality, while Mediterranean and Nordic diets showed benefits for stroke and cardiovascular mortality. Physical activity was associated with reduced all-cause and cardiovascular mortality. Comprehensive lifestyle interventions showed no significant cardiovascular benefit. Most evidence was of moderate or low certainty due to methodological limitations, including bias, imprecision, and inconsistency.</p> Conclusion <p>Weight control interventions are associated with improved all-cause mortality and cardiovascular outcomes. High- to moderate-quality evidence supported benefits of GLP1-RAs in individuals with type 2 diabetes or overweight. Dietary, surgical, and exercise interventions showed modest effects. No consistent cardiovascular benefit was observed for comprehensive lifestyle interventions.</p> <p></p>

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Effects of weight control interventions on cardiovascular outcomes: an umbrella review of systematic reviews and meta-analyses

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月25日

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  • Xiaomei Chen,
  • Xuge Zhang,
  • Xiang Xiang,
  • Xiang Fang,
  • Fei Wei,
  • Shenghong Feng

摘要

Background

Obesity and overweight are major risk factors for cardiovascular diseases. Although various weight control interventions have been evaluated individually, their comparative effectiveness across outcomes and populations remains uncertain.

Objectives

To evaluate the effects of weight control interventions on all-cause mortality and cardiovascular outcomes.

Methods

A comprehensive search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library from inception to June 2024. Meta-analyses reporting pooled effect sizes for all-cause mortality or cardiovascular outcomes were included. Reviews without quantitative synthesis were excluded. Risk of bias and methodological quality were assessed using A Measurement Tool to Assess Systematic Reviews and the Grading of Recommendations Assessment, Development and Evaluation approach. No new meta-analysis was conducted, relevant data were re-analyzed when required to ensure consistency. This review was registered in PROSPERO (CRD42024573542).

Results

Forty-seven effect sizes from 31 articles were extracted. Among pharmacologic interventions, high- to moderate-quality evidence showed that glucagon-like peptide-1 receptor agonists (GLP1-RAs) were associated with reduced all-cause mortality, major adverse cardiovascular events, stroke, cardiovascular mortality, myocardial infarction, and heart failure among individuals with type 2 diabetes or overweight/obesity. Bariatric surgery was consistently associated with reduced risks for all cardiovascular outcomes except atrial fibrillation. For dietary strategies, low-fat diets were linked to lower all-cause mortality, while Mediterranean and Nordic diets showed benefits for stroke and cardiovascular mortality. Physical activity was associated with reduced all-cause and cardiovascular mortality. Comprehensive lifestyle interventions showed no significant cardiovascular benefit. Most evidence was of moderate or low certainty due to methodological limitations, including bias, imprecision, and inconsistency.

Conclusion

Weight control interventions are associated with improved all-cause mortality and cardiovascular outcomes. High- to moderate-quality evidence supported benefits of GLP1-RAs in individuals with type 2 diabetes or overweight. Dietary, surgical, and exercise interventions showed modest effects. No consistent cardiovascular benefit was observed for comprehensive lifestyle interventions.