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Long-Term Impact of Clinical Obesity on Heart Failure Development and Prognosis: New Insights
Hongmin Liu1, Tong Liu2, Yuntao Wu1
1Department of Cardiology, Kailuan General Hospital, Tangshan, China.
Insights
Clinical obesity significantly increases the risk of developing heart failure (HF), but does not appear to raise mortality after HF diagnosis. Recognizing obesity as a disease aids HF prevention.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Clinical obesity is recognized as an independent disease.
- Its association with heart failure (HF) requires further investigation.
Purpose of the Study:
- To assess the impact of clinical obesity on the risk of new-onset heart failure (HF).
- To evaluate the effect of clinical obesity on all-cause mortality following HF development.
Main Methods:
- A cohort of 99,131 participants was classified based on obesity criteria.
- Cox proportional hazards models analyzed the association between clinical obesity and HF risk.
- All-cause mortality was examined in participants who developed HF.
Main Results:
- Clinical obesity was linked to a 63% increased risk of new-onset HF compared to nonobese individuals.
- HF risk escalated with the number of clinical obesity criteria present.
- No significant association was found between clinical obesity and increased all-cause mortality post-HF.
Conclusions:
- Clinical obesity is a significant risk factor for developing new-onset HF.
- Obesity's role in HF is attributed to excess weight and related clinical conditions.
- Classifying obesity as a disease may enhance HF prevention strategies.
Background:
The Lancet Diabetes & Endocrinology Commission recognizes clinical obesity as an independent disease, although its link to heart failure (HF) remains underexplored.
Objectives:
The goal of this study was to evaluate the impact of clinical obesity on new-onset HF risk and subsequent all-cause mortality after the development of HF.
Methods:
Clinical obesity was defined based on body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio, and 10 clinical criteria. A total of 99,131 participants from the Kailuan Study cohort were classified into nonobese, preclinical obesity, and clinical obesity groups. A Cox proportional hazards model was applied to assess the association between clinical obesity and the risk of new-onset HF, and all-cause mortality was examined among those with HF.
Results:
Over a median follow-up of 16.0 years, 3,280 participants developed HF, and there were 19,170 deaths from any cause. Compared with the nonobese group, clinical obesity was associated with a 63% higher risk of new-onset HF (adjusted [aHR]: 1.63; 95% CI: 1.49-1.77), with varying risks across HF subtypes. Within the clinical obesity group, HF risk increased with the number of clinical criteria: one (aHR: 1.50; 95% CI: 1.37-1.64), two (aHR: 1.91; 95% CI: 1.70-2.14), and three or more (aHR: 2.20; 95% CI: 1.80-2.68). However, clinical obesity was not associated with increased all-cause mortality after HF (aHR: 1.01; 95% CI: 0.90-1.15).
Conclusions:
These findings highlight clinical obesity as a risk factor for new-onset HF and all-cause mortality, driven both by excess weight and associated clinical conditions. Recognizing clinical obesity as an independent disease may support more effective HF prevention strategies.
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