Adiposity and Incidence of Heart Failure Hospitalization and Mortality
Key result
Higher body mass index was associated with increased risk of heart failure hospitalization or death (e.g., HR 1.39; 95% CI 1.15-1.68 in women at age 60), though this association declined with age.
Why the study?
Does higher body mass index and waist circumference increase the incidence of heart failure hospitalization and mortality in adult men and women?
Population
80,360 adults, comprising women aged 48 to 83 (n=36,873) and men aged 45 to 79 (n=43,487).
Comparison
Higher body mass index and waist circumference vs Lower body mass index and waist circumference
Design
Cohort
Follow-up
January 1, 1998, to December 31, 2004
Authors
Discussion
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Member takes
Implication
May inform earlier obesity interventions to reduce HF risk; leaves open whether associations are causal or modifiable by age.
Key Points
- This research investigates the relationship between body mass index (BMI) and the incidence of heart failure (HF) by age and waist circumference (WC).
- Analyzed self-reported height, weight, and waist circumference of 80,360 individuals aged 45 to 83.
- Determined HF hospitalization and death occurrences through administrative registers from 1998 to 2004.
- Used Cox proportional-hazards models to calculate hazard ratios for BMI and WC associations with HF.
- Hazard ratios for an interquartile range higher BMI were 1.39 (95% CI, 1.15 to 1.68) at age 60 and 1.13 (95% CI, 1.02 to 1.27) at age 75 for women.
- In men, hazard ratios were 1.54 (95% CI, 1.37 to 1.73) at age 60 and 1.25 (95% CI, 1.16 to 1.35) at age 75.
- A 10-cm higher WC was linked to a 15% to 18% increase in HF rates among women, while a 1 kg/m² increase in BMI indicated a 4% higher HF rate in men.
Study Design
Type
Cohort (n=80,360)
Structured PICO
Does higher body mass index and waist circumference increase the incidence of heart failure hospitalization and mortality in adult men and women?
P
Population
80,360 adults aged 45 to 83 followed between 1998 and 2004 for incident heart failure hospitalization or death.
E
Exposure
Higher body mass index (BMI) and waist circumference (WC)
C
Comparator
Lower body mass index (BMI) and waist circumference (WC)
O
Outcome
Composite of heart failure hospitalization or death between January 1, 1998, and December 31, 2004composite
Main Result
Hazard Ratio: 1.39 (95% CI 1.15–1.68)
Higher body mass index and waist circumference are associated with an increased risk of heart failure hospitalization and mortality, though the strength of the association with BMI declines with age.
Cite This Study
Levitan et al. (2009) conducted a cohort in Heart failure (n=80,360). Body mass index and waist circumference vs. Lower body mass index and waist circumference was evaluated on Heart failure hospitalization or death (HR 1.39, 95% CI 1.15-1.68). Higher body mass index was associated with increased risk of heart failure hospitalization or death (e.g., HR 1.39; 95% CI 1.15-1.68 in women at age 60), though this association declined with age.