Interactions of hypertension, obesity, left ventricular hypertrophy, and heart failure

daSilva‐deAbreu, Adrian; Alhafez, Bader Aldeen; Lavie, Carl J.; Milani, Richard V.; Ventura, Héctor O.

doi:10.1097/hco.0000000000000868

Cited by 16 publications

(12 citation statements)

References 74 publications

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“… 1 , 2 In many studies, factors that determine the clinical course of CS were evaluated and various risk factors were shown to contribute to negative outcomes. 3 Obesity, one of the risk factors traditionally known to be associated with worse outcomes in patients with heart failure (HF), 4 was also reported to contribute to negative outcomes in CS. 5 , 6 …”

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confidence: 99%

Impact of the Obesity Paradox Between Sexes on In‐Hospital Mortality in Cardiogenic Shock: A Retrospective Cohort Study

Kwon

Lee

Yang

et al. 2022

JAHA

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Background Several studies have shown that obesity is associated with better outcomes in patients with cardiogenic shock (CS). Although this phenomenon, the “obesity paradox,” reportedly manifests differently based on sex in other disease entities, it has not yet been investigated in patients with CS. Methods and Results A total of 1227 patients with CS from the RESCUE (Retrospective and Prospective Observational Study to Investigate Clinical Outcomes and Efficacy of Left Ventricular Assist Device for Korean Patients With Cardiogenic Shock) registry in Korea were analyzed. The study population was classified into obese and nonobese groups according to Asian Pacific criteria (BMI ≥25.0 kg/m 2 for obese). The clinical impact of obesity on in‐hospital mortality according to sex was analyzed using logistic regression analysis and restricted cubic spline curves. The in‐hospital mortality rate was significantly lower in obese men than nonobese men (34.2% versus 24.1%, respectively; P =0.004), while the difference was not significant in women (37.3% versus 35.8%, respectively; P =0.884). As a continuous variable, higher BMI showed a protective effect in men; conversely, BMI was not associated with clinical outcomes in women. Compared with patients with normal weight, obesity was associated with a decreased risk of in‐hospital death in men (multivariable‐adjusted odds ratio [OR], 0.63; CI, 0.43–0.92 [ P =0.016]), but not in women (multivariable‐adjusted OR, 0.94; 95% CI, 0.55–1.61 [ P =0.828]). The interaction P value for the association between BMI and sex was 0.023. Conclusions The obesity paradox exists and apparently occurs in men among patients with CS. The differential effect of BMI on in‐hospital mortality was observed according to sex. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02985008.

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confidence: 99%

Impact of the Obesity Paradox Between Sexes on In‐Hospital Mortality in Cardiogenic Shock: A Retrospective Cohort Study

Kwon

Lee

Yang

et al. 2022

JAHA

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“…Algahim et al found a significant regression in LVM and LVMI after bariatric surgery and suggested that this change is modulated by neurohumoral factors that may improve long-term survival [ 38 ]. Without significant weight loss, the reversal of left ventricular remodeling is also generally not achieved by blood pressure control alone [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Obesity is one of the most critical risk factors for atherosclerotic cardiovascular disease, type 2 diabetes, and other metabolic diseases, leading to the loss of nearly 20 years of life [ 2 – 4 ]. Weight loss helps improve ventricular remodeling and heart failure [ 5 ]. The metabolic complications of obesity are more closely related to visceral obesity than overall obesity [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Value of Four Anthropometric Indicators for Identifying Left Ventricular Hypertrophy in Chinese Hypertensive Patients

Cheng

Song

et al. 2022

International Journal of Hypertension

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Left ventricular hypertrophy (LVH) has been classified separately as an independent risk factor for hypertension. However, comparisons between different body size indices and left ventricular hypertrophy (LVH) in hypertensive populations have not been reported yet. In this study, we enrolled 4,639 hypertensive patients from rural China. Anthropometric indices and cardiovascular disease risk factor variables were measured and analyzed using Spearman’s correlation, logistic regression, and receiver operating characteristic (ROC) curve analyses. Patients in the highest quartile of body size indices were more likely to have left ventricular hypertrophy than those in the lowest quartile; these indices were BMI (adjusted OR: 3.55, 95% CI: 2.90; 4.35), WC (adjusted OR: 2.23, 95% CI: 1.84; 2.70), WHR (adjusted OR: 1.44, 95% CI: 1.18; 1.75), and WHtR (adjusted OR: 3.23, 95% CI: 2.62; 3.99). The areas under the ROC curves of BMI (AUC: 0.628, 95% CI: 0.612; 0.644), WHtR (AUC: 0.628, 95% CI: 0.560; 0.593), WHR (AUC: 0.530, 95% CI: 0.513; 0.547), and WC (AUC: 0.576, 95% CI: 0.513; 0.547) were all above 0.5, which indicated that the four anthropometric indicators may be associated with LVH. The four anthropometric indicators of obesity were identified as risk factors for LVH. Weight control might help reduce the risk of left ventricular hypertrophy.

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“…Although the obese group in this study had a higher mean LV ejection fraction, a strong relationship was observed between obesity, cardiomyopathy, and heart failure. Normalization of the left ventricular mass in obese and hypertensive individuals requires both normotension and weight loss [14].…”

Section: Discussionmentioning

confidence: 99%

Correlation Between Different Parameters of Acute Myocardial Infarction and Obesity

Alqahtani¹,

Omeish²,

Ghulam³

et al. 2022

Cureus

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Objective: To study if obesity had a detrimental effect on troponin after acute coronary syndrome. We investigated the effects of the body mass index (BMI) in post-myocardial infarction (MI) patients, and see the difference in troponin levels and other parameters between normal and overweight patients.Methodology: A retrospective cohort study was conducted. Data were extracted from the electronic medical files of patients hospitalized due to acute ST-elevation MI to examine the association between BMI and MI. Sixty-one patients were categorized into normal BMI category, overweight, and obese/morbid obesity groups using the baseline measurements, to assess the independent factors associated with a patient with a high BMI who had a MI.Results: In total, 61 post-myocardial infarction patients with a mean age of 56.9 ± 11.2 years were included in the study. The average BMI was 28.5 ± 6.5 kg/m 2 . Just more than a third (37.4%, n=23) were in the normal BMI category, 19 (31.2%) overweight, and 19 (31.2%) obese/morbid obesity. The mean left ventricle mass was 93.74 ± 32.69 gram and the mean left ventricular ejection fraction was 44.02% ± 10.02. A significant difference in the mean level of troponin and mean heart rate between the body mass index groups (normal vs. overweight groups) was noted. A fair correlation was noted between BMI and left ventricle mass. No statistically significant relation could be linked to high BMI with total cholesterol, low-density lipoprotein (LDL), or aspartate transferase/alanine transaminase (AST/ALT) levels.Conclusions: In this pilot study, the group with a high BMI had a statistically significant lower troponin level and higher mean heart rate. Such data need to be considered when assessing a patient's risk. In addition, obese persons with a MI had a higher left ventricle mass.

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Interactions of hypertension, obesity, left ventricular hypertrophy, and heart failure

Cited by 16 publications

References 74 publications

Impact of the Obesity Paradox Between Sexes on In‐Hospital Mortality in Cardiogenic Shock: A Retrospective Cohort Study

Impact of the Obesity Paradox Between Sexes on In‐Hospital Mortality in Cardiogenic Shock: A Retrospective Cohort Study

The Value of Four Anthropometric Indicators for Identifying Left Ventricular Hypertrophy in Chinese Hypertensive Patients

Correlation Between Different Parameters of Acute Myocardial Infarction and Obesity

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