Why the study?
Does the obesity paradox exist in primary prevention versus established cardiovascular disease?
Does the obesity paradox exist in primary prevention versus established cardiovascular disease?
The obesity paradox may only apply to patients with established cardiovascular disease, whereas in primary prevention, obesity remains a strong predictor of increased mortality.
out that the so-called reverse epidemiol-ogy of a better outcome associated with obesity occurs only in patients with estab-lished cardiovascular (CV) disease (CVD) including heart failure (refs. 1–35 in the review by Hainer and Aldhoon-Hainerova (1). At the primary prevention level, how-ever, studying large cohorts, e.g., the pop-ulation of 359,387 participants recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study with a follow-up of 9.7 years (2), increased waist circumference as a surrogate of obe-sity clearly was a strong predictor of in-creased mortality, and there are numerous
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Standl et al. (2013) studied this question.
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