Editor’s presentation: Overweight carries a higher risk for developing heart failure

High BMI increases the risk of heart failure Heart failure (HF) is a major public health problem associated with high mortality and morbidity; 1 however, its determinants are still poorly recognised. Here, in a randomised selected population study 798 men born in 1943 in Gothenburg, Sweden, were examined in 1993 (at 50 years of age) and re-examined 21 years later in 2014, with longitudinal follow-up. At 71 years of age, 52% men developed HF/cardiac dysfunction. Multivariable logistic regression demonstrated that elevated body mass index (BMI) at 50 years of age was the only independent risk factor for developing HF/cardiac dysfunction during the subsequent 21 years. For each unit (1 kg/m 2 ) of increased BMI, the odds ratio for stages C/D heart failure versus no heart failure/stage A increased by 1.20 after adjustment for smoking, sedentary lifestyle, systolic blood pressure, diabetes and hyperlipidemia. These findings carry two important messages. First, they demonstrate that at least half of this elderly population developed cardiac dysfunction; second, it provides an explanation for the increased burden of HF, because there is evidence of an increased prevalence of obesity worldwide, 2 and accordingly, obesity-associated HF, stressing the importance of promoting measures to prevent obesity and weight gain.