The obesity paradox in heart failure patients with preserved versus reduced ejection fraction: a meta-analysis of individual patient data

Background: In heart failure (HF), obesity, defined as body mass index (BMI) ⩾30 kg m −2 , is paradoxically associated with higher survival rates compared with normal-weight patients (the ‘obesity paradox’). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fract...

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Bibliographic Details
Published in:International Journal of Obesity 2014-08, Vol.38 (8), p.1110-1114
Main Authors: Padwal, R, McAlister, F A, McMurray, J J V, Cowie, M R, Rich, M, Pocock, S, Swedberg, K, Maggioni, A, Gamble, G, Ariti, C, Earle, N, Whalley, G, Poppe, K K, Doughty, R N, Bayes-Genis, A
Format: Article
Language:English
Subjects:
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Adult
Biological and medical sciences
Blood pressure
Body Mass Index
Body size
Cardiac output
Cardiology. Vascular system
Cardiovascular system
Clinical Medicine
Comorbidity
Confidence intervals
Congestive heart failure
Diabetes mellitus
Ejection fraction
Epidemiology
Etiology
Failure analysis
Female
Hazards
Health aspects
Health hazards
Health Promotion and Disease Prevention
Heart
Heart failure
Heart Failure - mortality
Heart Failure - physiopathology
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Hypertension
Internal Medicine
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
Ischemia
Klinisk medicin
Male
Medical sciences
Medicine
Medicine & Public Health
Meta-analysis
Metabolic Diseases
Mortality
Obesity
Obesity - complications
Obesity - mortality
original-article
Paradoxes
Patient outcomes
Patients
Physiological aspects
Prognosis
Proportional Hazards Models
Public Health
Risk Factors
Statistical models
Stroke Volume
Survival
Survival Analysis
Systematic review
Ventricle
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Summary:Background: In heart failure (HF), obesity, defined as body mass index (BMI) ⩾30 kg m −2 , is paradoxically associated with higher survival rates compared with normal-weight patients (the ‘obesity paradox’). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)). Patients and Methods: A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups:
ISSN:0307-0565
1476-5497
1476-5497
DOI:10.1038/ijo.2013.203