Meta-Analysis Comparing Frequency of Overweight Versus Normal Weight in Patients With New-Onset Heart Failure

Association between obesity and new-onset heart failure (HF) has repeatedly been established. Less is known about the risk of overweight with the development of HF. The aim of this systematic review and meta-analysis was to explore the association between overweight, obesity, and the incidence of new-onset HF. In this study, we systematically searched MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials from database inception through June 2017. Studies were included if they reported the association between overweight or obesity and new-onset HF compared with normal weight. DerSimonian and Laird random effect meta-analyses were used, and subgroup analyses were performed to explore the potential sources of heterogeneity. Of 2,184 retrieved articles, we identified 21 relevant studies with a total of 525,656 participants with 18,948 HF cases. Compared with the normal body weight index (body mass index < 25 kg/m²), overweight (body mass index 25 to 29.9 kg/m²) was associated with a 33% higher risk of developing HF (pooled risk ratios 1.33; 95% confidence interval 1.16 to 1.52; p <0.001), with substantial heterogeneity among studies (I² = 83.6%). In addition, class I, II, and III obesity were stepwise-associated with an increase in the risk of developing HF as 73%, 85% and 189%, respectively (all p <.001) compared with normal weight. In conclusion, compared with healthy normal-weight patients, these results show that both overweight patients were independently associated with a significantly higher incidence of HF. These results highlight the need for a better understanding of the potential mechanisms of overweight and HF.