Obesity Paradox: Comparison of Heart Failure Patients With and Without Comorbid Diabetes

2017 ◽  
Vol 26 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Kyoung Suk Lee ◽  
Debra K. Moser ◽  
Terry A. Lennie ◽  
Michele M. Pelter ◽  
Thomas Nesbitt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Obesity Paradox ◽  
Heart Failure Patients

Abstract P174: Factors Related to Decreased Readmission within 30 Days for Hispanic Heart Failure Patients

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Hong Seok Lee ◽  
Gerald Pekler ◽  
Fernand Visco ◽  
Savi Mushiyev
Keyword(s):  
Heart Failure ◽  
Readmission Rate ◽  
Central Obesity ◽  
Randomized Study ◽  
Obesity Paradox ◽  
Normal Weight ◽  
Obese Group ◽  
Heart Failure Patients ◽  
Number Of Patients ◽  
Heart Failure Exacerbation

Objective: This study was aimed to relate the obesity paradox to readmission and obesity. The obesity paradox remains controversial in the literature. Obesity has detrimental effects on heart failure, but has been found to be paradoxically associated with improved survival. We hypothesized that readmission in heart failure patients is associated with obesity. Method: We analyzed 732 patients who were admitted for heart failure exacerbation and enrolled in our heart failure program and excluded those who did not follow-up or patients discharged from the cardiology clinic. Patients who were readmitted within 30 days for heart failure exacerbation were investigated. 688 patients who have been followed since 2013 were included. BMI (body mass index) and WC (waist circumference) were classified according to NCEP-ATP III. Results: The number of normal weight (BMI <25kg/m 2 ), overweight (30 kg/m 2 >BMI≥25kg/m 2 ) and obesity (BMI≥30kg/m 2 ) were 35.7%, 35.1% and 29.1%, respectively. Central obesity (WC ≥94 cm for men ,and ≥80 for women) were 62%. The number of patients in our selected populations of HFrEF, HFpEF and HFpEF(i) were 456(67.9%),136(20.2%) and 68(11.9%) respectively. A higher readmission rate had a significantly associated with non-obese (BMI less than 30 kg/m 2) group compared to obese group(BMI more than 30 kg/m 2) in HFpEF patients. There was no significant association between central obesity and readmission. In addition, the absence of diabetes mellitus, an ICD (implantable cardioverter defibrillator), no prior cardiac catheterization and age over 65 were associated with a lower readmission rate. Conclusion: The obesity paradox with BMI applied to our study group. The obese group had a significant association with reduced readmission rate compared to the normal or overweight BMI group in HFpEF. WC was not associated with readmission. Higher BMI may be related to better cardiopulmonary fitness in HFpEF. To apply to clinical practice, a large randomized study should be warranted. Targeted management in different types of heart failure could be associated readmission.

Abstract 2936: Obesity and Mortality in Patients with Heart Failure and Preserved Systolic Function

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
John R Kapoor ◽  
Paul A Heidenreich
Keyword(s):  
Heart Failure ◽  
Proportional Hazards ◽  
Systolic Function ◽  
Total Mortality ◽  
Obesity Paradox ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Heart Failure Patients ◽  
Objective Evidence

Several large cohort studies document better survival in heart failure patients with decreased left ventricular ejection fraction (EF) and higher body mass index (BMI) compared to those with a lower BMI. It is unclear, though, if this “obesity paradox” applies to heart failure patients with preserved EF or if it extends to the very obese (BMI>35). We followed 1,235 consecutive patients with a prior diagnosis of heart failure and a preserved EF (≥50%) documented on echocardiography at one of three laboratories. We determined adjusted mortality and readmission rates at 1 year following the echocardiogram. Obesity (BMI>30) was noted in 542 patients (44%). The mean age of the cohort was 71 years, but this varied depending on BMI (73 years for BMI<25, 64 years for BMI> 35, p< 0.001). In a subset of patients with complete diastolic indices and LV mass measurements (n=405), 95% had objective evidence of diastolic dysfunction. Age-adjusted all-cause mortality (Figure ) at one year decreased with increasing BMI (31% if BMI < 25, 22% if BMI 25–29, 20% if BMI 30–35 and 19% if BMI>35, p=0.003). In a proportional hazards analysis that adjusted for patient history, demographics and laboratory values, the hazard ratios for total mortality (relative to a normal BMI) were 1.47 (95% CI, 1.06–2.05) for BMI<25, 0.95 (95% CI, 0.64 –1.42) for BMI 30 –35, and 0.83 (95% CI, 0.52–1.31), for BMI >35, p=0.046). Similar findings were noted for the composite endpoint of survival free from heart failure hospitalization. These data suggest that the obesity paradox applies to heart failure patients with preserved systolic function and extends to very obese patients (BMI>35).

scholarly journals Obesity paradox is not recognized in chronic heart failure patients with metabolic syndrome

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P1508-P1508
Author(s):  
T. Narumi ◽  
T. Watanabe ◽  
T. Arimoto ◽  
S. Kadowaki ◽  
Y. Otaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Metabolic Syndrome ◽  
Chronic Heart Failure ◽  
Obesity Paradox ◽  
Heart Failure Patients

scholarly journals OBESITY PARADOX AND HYPERTENSION: NEW INSIGHTS IN HEART FAILURE PATIENTS

2021 ◽  
Vol 39 (Supplement 1) ◽  
pp. e98-e99
Author(s):  
Konstantinos Imprialos ◽  
Konstantinos Koutsampasopoulos ◽  
Konstantinos Stavropoulos ◽  
Alexandra Katsimardou ◽  
Dimitrios Patoulias ◽  
...  
Keyword(s):  
Heart Failure ◽  
Obesity Paradox ◽  
Heart Failure Patients
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