Excess weight is associated with a significantly increased risk of coronary artery disease, heart failure, and death in the general population. In patients with established heart failure, studies suggest that a higher body mass index (BMI) results in better outcomes compared to patients with a “healthy BMI”. It is unclear if these findings are applicable to the population of outpatients with stable heart failure, as these observations are not the primary design or endpoints of these trials.
Given the uncertain role of obesity in the clinical management of patients with heart failure, we examined the relationship of weight and outcomes among our outpatients with stable disease.
We analyzed obese (BMI >30 kg/m2) compared to normal weight patients (BMI 18.5 –25 kg/m2) in our clinical information management for heart failure database (CIM-HF); there were 121 patients who fulfilled the criteria. Fifty-one patients had a normal BMI and seventy patients were classified as obese. There was no difference in age, gender or medical therapy for heart failure. More obese patients had a previous history of hypertension (90% vs. 71% p=0.008), diabetes (64% vs. 14% p=<0.0001), advanced New York Heart Association (NYHA) functional class III and IV (66% vs. 53%, p=0.046) compared to normal BMI patients. Hospitalizations were higher for obese patients (1.5 + 1.7 vs. 1.1 + 1), but this was not significant.
Symptoms are worse and co-morbidities are more prevalent in obese patients with systolic dysfunction and stable heart failure, compared to normal weight patients.
Obese patients with chronic stable heart failure and systolic dysfunction (ejection fraction <40%) have worse outcomes than similar patients with normal body mass index.
Jun Chiong, None.