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Updated: Aug 24, 2025

Author Spotlight: Exploring the Relationship Between Lipotoxicity and HFpEF
Published on: March 29, 2024
[Heart failure and obesity]
A A Safiullina1, T M Uskach1,2, K M Saipudinova1
1Chazov National Medical Research Center of Cardiology.
Insights
Obesity predicts cardiovascular diseases, but overweight patients with heart failure (HF) may have a better prognosis, a phenomenon known as the obesity paradox. This review explores HF, obesity, and the paradox in patient care.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Context:
- Obesity is a significant risk factor for cardiovascular diseases (CVD), including heart failure (HF).
- A notable subset of CVD patients, particularly those with HF, exhibit improved prognoses when overweight or mildly obese, challenging conventional risk factor models.
- The high prevalence of obesity within the heart failure population necessitates a deeper understanding of this complex relationship.
Purpose:
- To review clinical studies on obesity as a risk factor for heart failure.
- To elucidate the pathogenesis of heart failure in obese individuals.
- To examine the obesity paradox in heart failure and discuss treatment implications.
Summary:
- Obesity independently predicts cardiovascular diseases (CVD) and heart failure (HF).
- Paradoxically, overweight and mildly obese CVD patients often show better short- to moderate-term prognoses than leaner counterparts.
- This article synthesizes research on obesity's role in HF, its underlying mechanisms, the obesity paradox, and therapeutic strategies.
Impact:
- Informs clinical practice regarding risk stratification and management of obese heart failure patients.
- Highlights the need for nuanced approaches to obesity treatment in CVD, considering the obesity paradox.
- Contributes to the scientific understanding of metabolic influences on cardiovascular health and disease progression.
Abstract:
Obesity is an independent predictor of cardiovascular diseases (CVD), including heart failure (HF). Nevertheless, numerous studies have shown that patients with CVD who are overweight and slightly obese have a better short-term and moderate prognosis than thinner patients with CVD. This phenomenon has been called the obesity paradox. Understanding the obesity paradox is important in patients with HF, given the high prevalence of obesity in patients with HF. The article presents an overview of clinical studies devoted to the study of obesity as a risk factor for HF, the pathogenesis of HF in obesity, and highlights the issues of the obesity paradox and the treatment of obesity in this category of patients.
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