Key result
High BMI (≥25 kg/m2) was independently associated with a lower 1-year mortality rate compared to normal BMI in men with systolic heart failure (OR 0.543), but this obesity paradox was not observed in women.
Why the study?
The obesity paradox in heart failure remains controversial, and its prognostic value in patients hospitalized for systolic HF needed investigation.
Does high BMI reduce 1-year mortality in patients hospitalized for systolic heart failure?
Observational (n=2,484)
Yes
Does high BMI reduce 1-year mortality in patients hospitalized for systolic heart failure?
Odds Ratio: 0.543 (95% CI 0.355–0.832)
Absolute Event Rate: 6.9% vs 17.2%
p-value: p=<0.001
The obesity paradox in systolic heart failure appears to be sex-specific, with high BMI associated with lower 1-year mortality in men but not in women.
Sex-specific obesity paradox in systolic HF is hypothesis-generating; prospective validation required before considering sex-stratified BMI risk assessment.
PURPOSE: Obesity is often associated with better clinical outcomes in heart failure (HF). This so-called obesity paradox remains controversial. The aim of present study was to investigate the prognostic value of obesity in patients hospitalized for systolic HF. MATERIALS AND METHODS: We performed a pooled analysis of data from two multicenter, observational HF studies. Patients hospitalized for systolic HF were eligible for the present study. We divided the subjects into two groups, a normal body mass index (BMI) group and a high BMI group. Study endpoints included all-cause mortality and any re-hospitalization within 1 year. RESULTS: We enrolled 3145 patients (male, 1824; female, 1321). The high BMI group was significantly associated with lower 1-year mortality rate [odds ratio (OR), 0.543; 95% confidence interval (CI), 0.355-0.832] after adjusting for age, hypertension, diabetes, ischemic HF, previous myocardial infarction, serum creatinine level, anemia, and ejection fraction in men. After adjustment for clinical characteristics, high BMI was not significantly associated with 1-year mortality (OR, 0.739; 95% CI, 0.450-1.216) or 1-year re-hospitalization (OR, 0.958; 95% CI, 0.696-1.319) in women. CONCLUSION: In pooled analysis of data from two Korean HF registries, the high BMI group was independently associated with lower 1-year mortality rate from systolic HF, especially in men.
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Hong et al. (2017) conducted an observational in Systolic Heart Failure (n=2,484). High body mass index (≥25 kg/m2) vs. Normal body mass index (18.5-24.9 kg/m2) was evaluated on 1-year all-cause mortality in men (OR 0.543, 95% CI 0.355-0.832, p=<0.001). High BMI (≥25 kg/m2) was independently associated with a lower 1-year mortality rate compared to normal BMI in men with systolic heart failure (OR 0.543), but this obesity paradox was not observed in women.
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