Biykem Bozkurt1, Anita Deswal. 1. Department of Medicine, Baylor College of Medicine, Houston, TX, USA. bbozkurt@bcm.tmc.edu
Abstract
BACKGROUND: Obesity is considered as an independent risk factor for development of heart failure (HF); however, its role in the progression of HF independent of atherosclerotic heart disease, hypertension, and diabetes is not well described. METHODS: To identify the role of obesity in HF outcomes, we analyzed the Digitalis Investigation Group database with 7788 patients with chronic stable HF. Subjects with body mass index of > or = 18.5 and < 25 kg/m2 were categorized as normal weight, > or = 25.0 and < 30 kg/m2 as overweight, and > or = 30.0 kg/m2 as obese. RESULTS: Compared with normal weight, overweight or obese patients had lower all-cause mortality (37.8%, 32.4%, and 28.5%, P < .0001) and lower HF mortality (38.7%, 31.2%, and 33.6%, P = .01). After adjustment for differences in baseline characteristics, the overweight (HR 0.87, 95% CI 0.79-0.95, P = .002) and the obese (HR 0.82, 95% CI 0.73-0.92, P = .0005) had better survival rates compared with normal-weight groups. Similarly, the overweight (HR 0.76, 95% CI 0.65-0.88, P = .0003) or the obese (HR 0.79, 95% CI 0.63-0.88, P = .005) patients had better HF survival rates. After adjustment for baseline differences, the rate of hospitalizations was similar in the 3 groups. CONCLUSIONS: In patients with chronic symptomatic HF, obesity or overweight status was associated with a lower risk for mortality but a similar risk for hospitalization compared with normal weight status. Prospective studies evaluating the risks and benefits of sustenance of obesity or weight loss are needed in this population.
BACKGROUND:Obesity is considered as an independent risk factor for development of heart failure (HF); however, its role in the progression of HF independent of atherosclerotic heart disease, hypertension, and diabetes is not well described. METHODS: To identify the role of obesity in HF outcomes, we analyzed the Digitalis Investigation Group database with 7788 patients with chronic stable HF. Subjects with body mass index of > or = 18.5 and < 25 kg/m2 were categorized as normal weight, > or = 25.0 and < 30 kg/m2 as overweight, and > or = 30.0 kg/m2 as obese. RESULTS: Compared with normal weight, overweight or obesepatients had lower all-cause mortality (37.8%, 32.4%, and 28.5%, P < .0001) and lower HF mortality (38.7%, 31.2%, and 33.6%, P = .01). After adjustment for differences in baseline characteristics, the overweight (HR 0.87, 95% CI 0.79-0.95, P = .002) and the obese (HR 0.82, 95% CI 0.73-0.92, P = .0005) had better survival rates compared with normal-weight groups. Similarly, the overweight (HR 0.76, 95% CI 0.65-0.88, P = .0003) or the obese (HR 0.79, 95% CI 0.63-0.88, P = .005) patients had better HF survival rates. After adjustment for baseline differences, the rate of hospitalizations was similar in the 3 groups. CONCLUSIONS: In patients with chronic symptomatic HF, obesity or overweight status was associated with a lower risk for mortality but a similar risk for hospitalization compared with normal weight status. Prospective studies evaluating the risks and benefits of sustenance of obesity or weight loss are needed in this population.
Authors: Sameer Ather; Wenyaw Chan; Biykem Bozkurt; David Aguilar; Kumudha Ramasubbu; Amit A Zachariah; Xander H T Wehrens; Anita Deswal Journal: J Am Coll Cardiol Date: 2012-03-13 Impact factor: 24.094
Authors: Yashashwi Pokharel; Wensheng Sun; Salim S Virani; Vijay Nambi; Ron C Hoogeveen; Patricia P Chang; Chiadi E Ndumele; Scott D Solomon; Biykem Bozkurt; Elizabeth Selvin; Christie M Ballantyne; Anita Deswal Journal: JACC Heart Fail Date: 2016-12-21 Impact factor: 12.035