Key result
Obesity appears to confer a survival advantage in patients with heart failure, demonstrating an obesity paradox where weight loss is associated with adverse prognostic effects.
Why the study?
Does weight loss impact mortality risk in patients with chronic heart failure?
Does weight loss impact mortality risk in patients with chronic heart failure?
The paper highlights the obesity paradox in heart failure, where weight loss is associated with adverse outcomes, raising questions about optimal weight management strategies in clinical practice.
Evaluation of: Pocock SJ, McMurray JJV, Dobson J et al. Weight loss and mortality risk in patients with chronic heart failure in the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme. Eur. Heart J. 29, 2641-2650 (2008). Among patients with heart failure, the usual association between obesity and reduced survival appears to be turned on its head. Increasing numbers of studies appear to confirm the apparent protective effect of the 'obesity paradox' in heart failure. The adverse effects of weight loss and cachexia have been recognized among patients with chronic disease. The paper under evaluation clarifies and offers further insight into the impact of BMI and weight loss on prognosis in a large sample of heart failure patients. The results confirm and extend previous knowledge. They raise many questions, not only regarding the underlying pathophysiology that leads to this counterintuitive relationship observed in the obese heart failure group, but also as to how we should best approach and advise these patients on weight management in day-to-day practice.
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Kydd et al. (2009) conducted an editorial in heart failure. Obesity and weight loss was evaluated on mortality risk. Obesity appears to confer a survival advantage in patients with heart failure, demonstrating an obesity paradox where weight loss is associated with adverse prognostic effects.
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