Impact of Body Mass Index on Heart Failure by Race/Ethnicity From the Get With The Guidelines–Heart Failure (GWTG–HF) Registry

Abstract

This work is one of the first suggesting the obesity paradox for 30-day mortality exists at all BMI levels in HFrEF but not in patients with HFpEF. Higher BMI was associated with lower 30-day mortality across racial/ethnic groups in a manner inconsistent with the J-shaped relationship noted for coronary artery disease. The differential slope of obesity and mortality among HFpEF and patients with HFrEF potentially suggests differing mechanistic factors, requiring further exploration.

Effects of Adipocyte Expansion on Cardiovascular System and Ongoing Debate over Obesity Paradox

“…Numerous studies and meta-analyses have reported that obese patients with established heart failure have a better prognosis than nonobese patients. 32) This phenomenon, known as the 'obesity paradox', is found both in the short and long term and in every race and ethnicity group, 33) although it exhibits differential slopes of BMI and mortality for different types of heart failure to a certain extent. Moreover, pre-morbid obesity 6 months before the onset of heart failure has lower mortality compared to normal BMI patients.…”

Should patients become obese before transcatheter aortic valve implantation?

“…It has been reported to be associated with comorbidities such as hypertension, diabetes mellitus, and dyslipidaemia, as well as diseases such as cardiovascular and cerebrovascular disease [1]. Despite these associations, the so-called obesity paradox, a phenomenon indicating that obese patients actually have better survival, has been repeatedly reported in various conditions [2][3][4][5][6][7].…”

Trajectories of Waist-to-Hip Ratio and Adverse Outcomes in Heart Failure with Mid-Range Ejection Fraction

“…Obesity is a known risk factor for the progression of HF [6]; however, a large body of evidence from epidemiologic studies has shown an obesity paradox, i.e., a higher body mass index (BMI) predicts a lower risk of death in patients with HF [7][8][9]. The precise pathophysiological mechanisms regarding this paradox remain uncertain.…”