Key result
Obesity is an independent risk factor for developing heart failure, but once heart failure has developed, it appears to confer a beneficial influence on prognosis known as the obesity paradox.
Why the study?
Does weight loss improve outcomes in obese patients with heart failure?
There is a critical need for further research to determine whether weight loss interventions are beneficial for patients with heart failure and obesity, given the observed 'obesity paradox'.
Answers are grounded in this paper and cite their sources.
May warrant caution against routine weight loss advice in obese HF; leaves open whether intentional reduction improves outcomes.
Obesity is an independent risk factor for developing heart failure and the combination of the two disease states will prove to be a significant health burden over the coming years. Obesity is likely to contribute to the development of heart failure through a variety of mechanisms, including structural and functional changes, lipotoxicity and steatosis and altered substrate selection. However, once heart failure has developed, it seems that obesity confers a beneficial influence on prognosis in what has been termed the 'obesity paradox'. This may be a statistical phenomenon, but it should be considered that there is truly a protective state in the physiology of obesity. There is little evidence regarding the impact of weight loss in obese heart failure and whether or not this is beneficial. There have been small studies regarding the cardiovascular effects of both dietary weight loss and bariatric surgery, but few in heart failure. This is an important and increasingly relevant clinical question which must be addressed.
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Rayner et al. (2015) conducted a review in Obesity and heart failure. Weight loss was evaluated. Obesity is an independent risk factor for developing heart failure, but once heart failure has developed, it appears to confer a beneficial influence on prognosis known as the obesity paradox.
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