Key result
Higher BMI, higher systolic blood pressure, and a history of stroke were independently associated with higher odds of having HFpEF compared to HFrEF in Indian outpatients.
Why the study?
Data on heart failure phenotypes in India remain limited.
What clinical characteristics and comorbidities are independently associated with the HFpEF phenotype compared to HFrEF in Indian outpatients?
Cross-Sectional (n=1,207)
Yes
What clinical characteristics and comorbidities are independently associated with the HFpEF phenotype compared to HFrEF in Indian outpatients?
Indian outpatients with HFpEF exhibit a distinct hypertensive, metabolic, and vascular comorbidity profile compared to those with HFrEF, supporting phenotype-directed management.
Answers are grounded in this paper and cite their sources.
May aid HF phenotype differentiation in Indian outpatients; hypothesis-generating for targeted strategies pending prospective validation.
BACKGROUND: Data on heart failure (HF) phenotypes in India remain limited. We examined clinical characteristics and factors associated with HF phenotype defined according to ejection fraction (EF) in a large multicentre outpatient cohort. METHODS: We performed a retrospective cross-sectional analysis of adult HF outpatients with documented EF at centres across India (April 2021-March 2023). Patients were classified as HFrEF (EF ≤40%), HFmrEF (41-49%), or HFpEF (≥50%); multivariable logistic regression identified factors associated with phenotype. RESULTS: Among 1,207 patients (62 ± 10 years; 73% male), HFrEF was present in 822 (68.1%), HFmrEF in 89 (7.4%), and HFpEF in 296 (24.5%). Patients with HFpEF had higher systolic blood pressure (153 ± 26 vs 122 ± 25 mmHg), higher body mass index (BMI; 27.5 ± 4.9 vs 26.4 ± 4.4 kg/m2), and more chronic kidney disease (45% vs 23%) and stroke (27% vs 6.2%) than those with HFrEF (all p ≤ 0.003). Ischaemic heart disease (66% vs 56%; p = 0.002) and higher NT-proBNP (median 3,705 [481-6,232] vs 140 [121-521] pg/mL; p < 0.001) were more common in HFrEF. In multivariable analysis, higher BMI (OR 1.35 per 5 kg/m2, 95% CI 1.10-1.65), higher systolic blood pressure (OR 1.48 per 10 mmHg, 95% CI 1.37-1.60), and stroke (OR 1.99, 95% CI 1.11-3.54) were associated with higher odds of HFpEF, whereas higher NT-proBNP (OR 0.46, 95% CI 0.40-0.53) and diabetes (OR 0.56, 95% CI 0.38-0.83) were associated with lower odds of HFpEF. CONCLUSIONS: Higher BMI and blood pressure were associated with HFpEF, whereas elevated NT-proBNP and diabetes were associated with HFrEF. These cross-sectional associations may support phenotype-specific management of HF.
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Sharma et al. (2026) conducted a cross-sectional in Heart Failure (n=1,207). Clinical characteristics (e.g., history of stroke) vs. No history of stroke was evaluated on Association of clinical characteristics with HFpEF phenotype compared to HFrEF phenotype (OR 1.99, 95% CI 1.11-3.54). Higher BMI, higher systolic blood pressure, and a history of stroke were independently associated with higher odds of having HFpEF compared to HFrEF in Indian outpatients.
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