Key result
Weight loss ≥5% is linked to ~42% higher mortality in HFpEF vs weight stability.
Why the study?
The associations of weight loss or gain with all-cause mortality risk in patients with HFpEF were not well established.
Does weight loss or gain affect all-cause mortality risk in non-lean patients with HFpEF?
Cohort (n=1,515)
Yes
Does weight loss or gain affect all-cause mortality risk in non-lean patients with HFpEF?
In non-lean patients with HFpEF, weight loss of ≥5% over 1 year is independently associated with a higher risk of all-cause mortality, highlighting the obesity paradox in this population.
Answers are grounded in this paper and cite their sources.
Unintentional weight loss signals higher mortality risk in HFpEF; leaves open whether serial weight monitoring refines prognostication.
Aims: The aim of the study was to determine the associations of weight loss or gain with all-cause mortality risk in heart failure with preserved ejection fraction (HFpEF). Methods and Results: Non-lean patients from the Americas from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist study were analyzed (n = 1,515). Weight loss and weight gain were defined as a decrease or increase in weight ≥5% between baseline and 1 year. To determine the associations of weight change and mortality risk, we used adjusted Cox proportional hazards models and restricted cubic spline models. The mean age was 71.5 (9.6) years. Weight loss and gain were witnessed in 19.3 and 15.9% patients, respectively. After multivariable adjustment, weight loss was associated with higher risk of mortality (HR 1.42, 95% CI 1.06–1.89, P = 0.002); weight gain had similar risk of mortality (HR 0.98, 95% CI 0.68–1.42, P = 0.932) compared with weight stability. There was linear relationship between weight change and mortality risk. The association of weight loss and mortality was different for patients with and without diabetes mellitus (interaction p = 0.009). Conclusion: Among patients with HFpEF, weight loss was independently associated with higher risk of all-cause mortality, and weight gain was not associated with better survival. Clinical Trial Registration: https://clinicaltrials.gov , Identifier: NCT00094302.
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Huang et al. (2021) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) (n=1,515). Weight loss (≥5% decrease in weight) vs. Weight stability (<5% weight change) was evaluated on All-cause mortality (HR 1.42, 95% CI 1.06-1.89, p=0.002). Among patients with heart failure with preserved ejection fraction, weight loss of 5% or more was independently associated with a 42% higher risk of all-cause mortality (HR 1.42) compared with weight stability.
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