Heart failureInfluence of Etiology of Heart Failure on the Obesity Paradox
Section snippets
Methods
The present study was a multicenter analysis of patients with HF from the exercise testing laboratories at San Paolo Hospital (Milan, Italy), Wake Forrest University Baptist Medical Center (Winston-Salem, North Carolina), LeBauer Cardiovascular Research Foundation (Greensboro, North Carolina), Veterans Affairs Palo Alto Health Care System (Palo Alto, California), and Virginia Commonwealth University (Richmond, Virginia). A total of 1,160 patients diagnosed with chronic HF were included. The
Results
The baseline and CPX characteristics for the study group subdivided according to HF etiology and BMI are listed in Table 1. The ischemic HF subgroup was significantly older and included more men compared to the nonischemic HF group, irrespective of BMI classification. Within both HF etiology subgroups, patients classified as obese were significantly younger. A significantly lower percentage of normal weight subjects were prescribed a β-blocking agent at testing, irrespective of the HF etiology.
Discussion
The results of the present investigation are consistent with those of previous trials,2, 7 demonstrating that a greater BMI, although it increases the risk of the development of HF,8 improves survival once a patient has been diagnosed with HF. Previous investigations have used various low-end thresholds to define normal weight, including ≥18.5 kg/m2 and ≥22.0 kg/m2.9, 10 Our findings are consistent with those of previous investigations by demonstrating a poor prognosis for normal weight
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Cited by (39)
Obesity Paradox in Heart Failure Revisited: Etiology as Effect Modifier
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2018, European Journal of Internal MedicineCitation Excerpt :As demonstrated by Aquilani and co-workers, among patients with HF muscle protein balance is preserved only in obese subjects, while an increase in muscle protein degradation and in amino acid release is observed in non-obese subjects [130]. Interestingly, Zamora and colleagues found differences in the prognosis on the basis of HF etiology: in non-ischemic HF group the better prognosis is observed in obese individuals, while the OP disappears in ischemic group [116], in contrast with previous observations [131]. High arterial pressure values in obese subjects allow a more intensive treatment with cardio-protective medications, such as β-blockers and renin-angiotensin-aldosterone system inhibitors [132].
Effect of Heart Failure Secondary to Ischemic Cardiomyopathy on Body Weight and Blood Pressure
2017, American Journal of CardiologyObesity and Cardiovascular Disease Prevention
2017, Practical Guide to Obesity Medicine
This study was supported in part by Grants R37AG18915 and P60AG10484 from the National Institutes of Health, Bethesda, Maryland.