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Obesity and heart failure: exploring the cardiometabolic axis
Jennifer J Rayner1, Ines Abdesselam1, Jiliu Pan1
1Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.
Cardiovascular Research
|June 3, 2025
Summary
Obesity significantly increases heart failure (HF) risk, creating a detrimental cycle. Emerging evidence suggests managing obesity and insulin resistance in HF patients offers substantial benefits, potentially revolutionizing treatment approaches.
Area of Science:
- Cardiology
- Metabolic Disorders
- Public Health
Background:
- Obesity is a major global public health crisis with escalating incidence.
- Obesity is a primary risk factor for numerous life-limiting conditions, notably heart failure (HF).
- Despite advances in pharmacotherapy, HF incidence and mortality rates remain high.
Purpose of the Study:
- To review the pathophysiological interplay between obesity and heart failure.
- To examine the evidence for managing obesity in patients with established heart failure.
- To highlight emerging developments in the treatment of obesity in HF.
Main Methods:
- This is a narrative review.
- The review synthesizes existing literature on the 'vicious cycle' of obesity and HF.
- It explores pathophysiological mechanisms including hemodynamic, neuroendocrine, inflammatory, and intracellular changes.
Main Results:
- Obesity presents multifaceted physiological challenges, contributing to a complex pathophysiological cycle with HF.
- Management of obesity and insulin resistance in HF, once controversial, now shows significant benefits.
- Growing evidence supports proactive obesity management in HF patients.
Conclusions:
- Obesity and heart failure are intricately linked multisystem disorders.
- Addressing obesity in HF patients is crucial and increasingly supported by evidence.
- New therapeutic strategies may revolutionize the management of obesity in heart failure.
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