The epidemiology, clinical characteristics, and burden of heart failure with or without obesity in US patients

OBJECTIVE: This study aimed to assess the prevalence of heart failure (HF), including HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF), among patients with obesity, and the prevalence of obesity in patients with these HF subgroups between 2019 and 2023. Additionally, it sought to describe the clinical burden, comorbidities, and medication used across five distinct patient subgroups. METHODS: A non-interventional retrospective study using Komodo Healthcare Map data was conducted. Patients were categorized into five subgroups: HFpEF with obesity, HFpEF without obesity, HFrEF with obesity, HFrEF without obesity, and obesity without HF. Annual and overall prevalence rates were calculated, and clinical characteristics, comorbidities, and concomitant medication use were analyzed across subgroups. RESULTS: A total of 44,574,028 patients were included in the study. HF prevalence in obesity was 852.84 per 10,000. Obesity prevalence among HF patients was 6872.29 per 10,000, with a particularly high rate among those with HFpEF. Patients with obesity and HF were younger and had elevated rates of hypertension, dyslipidemia, type 2 diabetes, obstructive sleep apnea, and chronic kidney disease. Compared to HF patients without obesity, those with obesity had significantly greater use of antihypertensives, lipid-lowering agents, and antidiabetics. Adjusted analyses showed significantly higher odds of multiple comorbidities and medication use in patients with obesity and HF compared to non-obese or non-HF subgroups. CONCLUSION: Obesity is common in HF, especially HFpEF, and associated with greater clinical and medication burdens, underscoring the need for targeted strategies to manage both conditions and reduce associated complications.