Obesity as a prognostic factor in chronic symptomatic heart failure

Area of Science:

• Cardiology
• Obesity Medicine
• Public Health

Background:

• Obesity is a known risk factor for heart failure (HF).
• The specific impact of obesity on HF progression, independent of other conditions like atherosclerosis, hypertension, and diabetes, requires further clarification.
• Understanding weight-related outcomes in HF is crucial for patient management.

Purpose of the Study:

• To investigate the association between body mass index (BMI) categories and outcomes in patients with chronic stable heart failure (HF).
• To determine if obesity or overweight status influences mortality and hospitalization rates in HF patients independently of other risk factors.

Main Methods:

• Analysis of the Digitalis Investigation Group database, including 7788 patients with chronic stable HF.
• Patients were categorized by BMI: normal weight (18.5–24.9 kg/m²), overweight (25.0–29.9 kg/m²), and obese (≥30.0 kg/m²).
• Outcomes including all-cause mortality, HF mortality, and hospitalization rates were compared across BMI groups after statistical adjustments.

Main Results:

• Overweight and obese patients exhibited significantly lower all-cause mortality and HF-specific mortality compared to normal-weight individuals.
• Adjusted analyses confirmed that overweight (HR 0.87) and obese (HR 0.82) patients had improved survival rates.
• Hospitalization rates were comparable across all BMI categories (normal weight, overweight, and obese).

Conclusions:

• In patients with chronic symptomatic heart failure, overweight or obesity is associated with reduced mortality risk.
• Hospitalization risk is similar between normal-weight, overweight, and obese individuals with heart failure.
• Further prospective research is warranted to explore the benefits and risks of maintaining obesity or pursuing weight loss in the heart failure population.