Obesity and the Obesity Paradox in Heart Failure

Abstract

Obesity continues to be a public health problem in the general population, and also significantly increases the risk for the development of new-onset heart failure (HF). However, in patients with already-established, chronic HF, overweight and mild to moderate obesity is associated with substantially improved survival compared to normal weight patients; this has been termed the "obesity paradox". The majority of studies measure obesity by body mass index, but studies utilizing less-frequently used measures of body fat and body composition, including waist circumference, waist-hip ratio, skinfold estimates, and bioelectrical impedance analysis also confirm the obesity paradox in HF. Other areas of investigation such as the relationship of the obesity paradox to cardiorespiratory fitness, gender, and race are also discussed. Finally, this review explores various explanations for the obesity paradox, and summarizes the current evidence for intentional weight loss treatments for HF in context.

Obesity and its cardiovascular effects

“…Along these lines, in CHD, it appears that there is a solid obese paradox, especially with BMI, yet additionally with BF and central obesity, displaying the best forecast noted in overweight CHD individual rather than those with more extreme weight . Thus, an investigation by Clark et al demonstrated that both higher BMI and higher WC were related to better HF occasion–free survival …”

Non-Systematic Review of Diet and Nutritional Risk Factors of Cardiovascular Disease in Obesity

“…Furthermore, greater lean mass, which can be reflected in a higher BMI, is associated with better cardiorespiratory fitness levels. Greater fitness levels may be associated with an improved health condition [72,73].…”

Factors Associated with Inpatient Mortality after Intracerebral Hemorrhage: Updated Information from the United States Nationwide Inpatient Sample

“…This has been studied in various cardiovascular and cerebrovascular disorders. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] Observation of obesity paradox in intracerebral hemorrhage is reported in fewer studies. Of interest for our study, Dangayach et al 37 reported an overweight or obese status (BMI 25 kg/m2) was associated with twice the odds of having a good outcome compared with patients with BMI less than 25 kg/m2.…”