A new Brazilian guideline states that all adult patients with overweight or obesity must have their cardiovascular condition evaluated and categorized. The document was prepared by the Brazilian Association for the Study of Obesity and Metabolic Syndrome (Abeso), Brazilian Society of Diabetes (SBD), Brazilian Society of Cardiology (SBC), Brazilian Society of Endocrinology and Metabology (SBEM) and Brazilian Sleep Academy (ABS).
The Brazilian -based Brazilian guideline of 2025 for the management of obesity and prevention of cardiovascular diseases and complications associated with obesity also provides that adult patients aged 30 to 79 years with overweight or obesity, without prior cardiovascular disease, should have their cardiovascular condition evaluated through the preventability of infarction, stroke and stroke and stroke and stroke and stroke heart failure over the next ten years.
According to the document, health professionals should categorize the cardiovascular risk of overweight or obesity patients as low, moderate and high risk, as described below:
– Low risk: people with overweight or obesity, with body mass index (BMI) less than 40 and age under 30 years, which have no cardiovascular risk factor; Overweight or obese people over 30 years old, with cardiovascular risk calculated by the Prevent Score as less than 5% in 10 years.
– Moderate risk: people with overweight or obesity, with IMC less than 40, who have never had cardiovascular events, with one or more risk factors; People overweight or obesity, with IMC less than 40, in primary prevention, with cardiovascular risk calculated by the Prevent Score as between 5% and less than 20% in ten years.
– High risk: People with confirmed chronic coronary disease, acute myocardial infarction, ischemic stroke or transient ischemic accident, peripheral obstructive arterial disease, revascularization in any arterial territory; People in primary prevention, with cardiovascular risk calculated by the Prevent Prevent greater or equal to 20% in ten years; People with type 2 diabetes for over ten years; People with chronic kidney disease 3b; People with coronary calcium score greater than 100 without diabetes or larger than 10 with diabetes.
Another category defined by the guideline deals with high risk specifically for heart failure, valid for people with BMI greater than 40, even asymptomatic; people with obesity, diabetes and associated hypertension; People with obstructive apnea of severe sleep; people with atrial fibrillation; People with chronic renal disease grade 3b; People with risk of heart failure calculated by the Prevent Prevent Equipment equal to or greater than 20% for the next ten years; People with established cardiovascular atherosclerotic disease; People with symptoms suggestive of heart failure.
Slimming pens
The new guideline also highlights the role of substances such as liraglutide and semaglutide, active ingredients of GLP-1 agonist drugs, popularly known as weight loss pens, in combating overweight and obesity. The document recommends, for example, the use of liraglutide for adult patients with overweight or obesity and moderate or high cardiovascular risk with the purpose of weight loss and reduced cardiovascular risk.
Another recommendation includes treatment with semaglutide in people with IMS greater than or equal to 27, without diabetes and established cardiovascular disease (secondary prevention) with the objective of reducing the risk of deaths related to cardiovascular disease, acute myocardial infarction and stroke.
The document also recommends weight loss for people with obesity and obstructive moderate to severe sleep apnea, with the aim of improvement or remission of apnea; For people with obesity and established heart failure to improve quality of life, cardiac function and exercise capacity.
