Seo-Young Lee1, Hack-Lyoung Kim1, Myung-A Kim2, Jin Joo Park3, Dong-Ju Choi3, Jae-Joong Kim4, Eun-Seok Jeon5, Myeong-Chan Cho6. 1. Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea. 2. Department of Internal Medicine, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Republic of Korea. Electronic address: kma@snu.ac.kr. 3. Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 4. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul. 5. Department of Internal Medicine, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea. 6. Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Seoul, Republic of Korea.
Abstract
BACKGROUND: Although the survival benefit of obesity has been suggested in patients with heart failure (HF), the impact of sex on obesity paradox is less clear. This study was performed to investigate whether there is a sex difference in the association between body mass index (BMI) and long-term clinical outcomes in patients hospitalized for HF. METHOD: A total of 2616 patients hospitalized for HF (Mean age 66 years and 52% males) from the nation-wide registry database were analyzed. Patients were categorized using baseline BMI as normal (18.5 to 22.9 kg/m2), overweight (23 to 27.4 kg/m2) and obese (≥ 27.5 kg/m2). Their all-cause mortality and long-term composite events, including all-cause mortality and HF readmission, were assessed according to the BMI groups. RESULTS: During the median follow-up period of 1499 days, there were 662 patients (25.3%) with all-cause mortality and 1071 patients (40.9%) with composite events. Compared to the normal weight group, the overweight (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.51-0.99; P = 0.045) and obese (HR, 0.53; 95% CI, 0.29-0.95; P = 0.032) group showed lower all-cause mortality rates even after adjusting for confounding factors in the male patients. Otherwise, BMI was not associated with composite events in males; it was not associated with all-cause mortality or composite events in females in the multivariable analyses (P > 0.05 for each). CONCLUSIONS: Among patients with HF, a greater BMI was associated with low all-cause mortality in males, but not in females. Obesity paradox should be considered in the management of HF patients.
BACKGROUND: Although the survival benefit of obesity has been suggested in patients with heart failure (HF), the impact of sex on obesity paradox is less clear. This study was performed to investigate whether there is a sex difference in the association between body mass index (BMI) and long-term clinical outcomes in patients hospitalized for HF. METHOD: A total of 2616 patients hospitalized for HF (Mean age 66 years and 52% males) from the nation-wide registry database were analyzed. Patients were categorized using baseline BMI as normal (18.5 to 22.9 kg/m2), overweight (23 to 27.4 kg/m2) and obese (≥ 27.5 kg/m2). Their all-cause mortality and long-term composite events, including all-cause mortality and HF readmission, were assessed according to the BMI groups. RESULTS: During the median follow-up period of 1499 days, there were 662 patients (25.3%) with all-cause mortality and 1071 patients (40.9%) with composite events. Compared to the normal weight group, the overweight (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.51-0.99; P = 0.045) and obese (HR, 0.53; 95% CI, 0.29-0.95; P = 0.032) group showed lower all-cause mortality rates even after adjusting for confounding factors in the male patients. Otherwise, BMI was not associated with composite events in males; it was not associated with all-cause mortality or composite events in females in the multivariable analyses (P > 0.05 for each). CONCLUSIONS: Among patients with HF, a greater BMI was associated with low all-cause mortality in males, but not in females. Obesity paradox should be considered in the management of HF patients.
Authors: Owen Igbinosa; Ahmed Brgdar; Joseph Asemota; Mohamed E Taha; Jin Yi; Anthony Lyonga Ngonge; Swati Vanaparthy; Raccquel Hammonds; Joseph Talbet; Diannemarie Omire-Mayor; Julius Ngwa; Muhammad Rizwan; Mehrotra Prafulla; Isaac Opoku Journal: Cureus Date: 2022-05-02