Adiposity, body composition and ventricular–arterial stiffness in the elderly: the Atherosclerosis Risk in Communities Study

Fernandes-Silva, Miguel Morita; Shah, Amil M.; Claggett, Brian; Cheng, Susan; Tanaka, Hirofumi; Silvestre, Odílson Marcos; Nadruz, Wilson; Borlaug, Barry A.; Solomon, Scott D.

doi:10.1002/ejhf.1188

Cited by 36 publications

(23 citation statements)

References 52 publications

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“…The only exception are SGLT2 inhibitors whose administration to diabetic patients at high risk of CV events was associated with a lower rate of the primary outcomes and HF hospitalizations. 207 Further to a mere assessment of body mass index, abdominal fat, measured via waist-to-hip ratio has a tighter relationship with outcomes, especially in female patients. Losing muscle with or without weight loss impairs functional capacity, quality of life, and outcome to a larger extent than weight loss alone.…”

Section: Comorbiditiesmentioning

confidence: 99%

“…206 Adiposity is associated with increased ventricular-arterial stiffness among the elderly and suggest a potential role in the development of HF. 207 Further to a mere assessment of body mass index, abdominal fat, measured via waist-to-hip ratio has a tighter relationship with outcomes, especially in female patients. 208 Cancer therapies are associated with side effects including up to nine categories of cardiovascular complications.…”

Section: Comorbiditiesmentioning

confidence: 99%

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Highlights in heart failure

et al. 2019

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Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in studies in patients hospitalized for acute HF. More recently, DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 (SGLT2) inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HFpEF research are summarized and reviewed in this article.A multiparametric approach is often proposed for risk stratification of HF patients. The prognostic accuracy of the metabolic exercise test data combined with cardiac and kidney indexes risk score was found as superior to the HF Survival Score and Seattle HF model risk scores in a cohort of 6112 1106 D. Tomasoni et al.

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Section: Comorbiditiesmentioning

confidence: 99%

Section: Comorbiditiesmentioning

confidence: 99%

Highlights in heart failure

et al. 2019

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“…The majority of previous studies on higher BMI, other obesity parameters, and HF risk did not account for differences in CRF levels. It has been suggested that a potential mechanism by which obesity parameters such as BMI, WC, and body fat percentage might contribute to the development of HF, is through increased arterial stiffness . Recent evidence suggests that CRF may mediate the risk of HF associated with BMI, and high CRF may attenuate the deleterious impact of obesity on HF risk .…”

Section: Individual Studies and Meta‐analyses Of Prospective Studies mentioning

confidence: 99%

Heart failure risk reduction: is fit and overweight or obese better than unfit and normal weight?

Kunutsor

Laukkanen

2019

European J of Heart Fail

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“…Body mass index (BMI) and the waist‐to‐hip ratio are major risk factors and prognostic variables in patients with HF . Echouffo‐Tcheugui et al .…”

Section: Devicesmentioning

confidence: 99%

September 2019 at a glance: focus on devices

Adamo

Lombardi

Metra

2019

European J of Heart Fail

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Adiposity, body composition and ventricular–arterial stiffness in the elderly: the Atherosclerosis Risk in Communities Study

Abstract: In this biracial community-based cohort, increased adiposity was associated with increased ventricular-arterial stiffness among the elderly and suggests a potential mechanism by which obesity might contribute to the development of HF.

Cited by 36 publications

References 52 publications

Highlights in heart failure

Highlights in heart failure

Heart failure risk reduction: is fit and overweight or obese better than unfit and normal weight?

September 2019 at a glance: focus on devices

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