Obesity and the Obesity Paradox in Heart Failure

Obesity continues to be a public health problem in the general population, and also significantly increases the risk for the development of new-onset heart failure (HF). However, in patients with already-established, chronic HF, overweight and mild to moderate obesity is associated with substantiall...

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Veröffentlicht in:	Progress in cardiovascular diseases Jg. 61; H. 2; S. 151 - 156
Hauptverfasser:	Horwich, Tamara B., Fonarow, Gregg C., Clark, Adrienne L.
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States Elsevier Inc 01.07.2018
Schlagworte:	Body mass index Heart failure Obesity paradox Waist circumference Heart failure Heart failure with preserved ejection fraction Body fat United States Cardiovascular disease Oxygen uptake Epicardial adipose tissue Right ventricle or ventricular Body mass index Waist circumference Bioelectrical impedance analysis Computed tomography Left ventricular ejection fraction Obesity paradox Cardiorespiratory fitness Minute ventilation/carbon dioxide production Dual energy x-ray absorptiometry Heart Failure with reduced ejection fraction
ISSN:	0033-0620, 1873-1740, 1532-8643, 1873-1740
Online-Zugang:	Volltext
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Abstract	Obesity continues to be a public health problem in the general population, and also significantly increases the risk for the development of new-onset heart failure (HF). However, in patients with already-established, chronic HF, overweight and mild to moderate obesity is associated with substantially improved survival compared to normal weight patients; this has been termed the “obesity paradox”. The majority of studies measure obesity by body mass index, but studies utilizing less-frequently used measures of body fat and body composition, including waist circumference, waist-hip ratio, skinfold estimates, and bioelectrical impedance analysis also confirm the obesity paradox in HF. Other areas of investigation such as the relationship of the obesity paradox to cardiorespiratory fitness, gender, and race are also discussed. Finally, this review explores various explanations for the obesity paradox, and summarizes the current evidence for intentional weight loss treatments for HF in context.
AbstractList	Obesity continues to be a public health problem in the general population, and also significantly increases the risk for the development of new-onset heart failure (HF). However, in patients with already-established, chronic HF, overweight and mild to moderate obesity is associated with substantially improved survival compared to normal weight patients; this has been termed the “obesity paradox”. The majority of studies measure obesity by body mass index, but studies utilizing less-frequently used measures of body fat and body composition, including waist circumference, waist-hip ratio, skinfold estimates, and bioelectrical impedance analysis also confirm the obesity paradox in HF. Other areas of investigation such as the relationship of the obesity paradox to cardiorespiratory fitness, gender, and race are also discussed. Finally, this review explores various explanations for the obesity paradox, and summarizes the current evidence for intentional weight loss treatments for HF in context. Obesity continues to be a public health problem in the general population, and also significantly increases the risk for the development of new-onset heart failure (HF). However, in patients with already-established, chronic HF, overweight and mild to moderate obesity is associated with substantially improved survival compared to normal weight patients; this has been termed the "obesity paradox". The majority of studies measure obesity by body mass index, but studies utilizing less-frequently used measures of body fat and body composition, including waist circumference, waist-hip ratio, skinfold estimates, and bioelectrical impedance analysis also confirm the obesity paradox in HF. Other areas of investigation such as the relationship of the obesity paradox to cardiorespiratory fitness, gender, and race are also discussed. Finally, this review explores various explanations for the obesity paradox, and summarizes the current evidence for intentional weight loss treatments for HF in context.Obesity continues to be a public health problem in the general population, and also significantly increases the risk for the development of new-onset heart failure (HF). However, in patients with already-established, chronic HF, overweight and mild to moderate obesity is associated with substantially improved survival compared to normal weight patients; this has been termed the "obesity paradox". The majority of studies measure obesity by body mass index, but studies utilizing less-frequently used measures of body fat and body composition, including waist circumference, waist-hip ratio, skinfold estimates, and bioelectrical impedance analysis also confirm the obesity paradox in HF. Other areas of investigation such as the relationship of the obesity paradox to cardiorespiratory fitness, gender, and race are also discussed. Finally, this review explores various explanations for the obesity paradox, and summarizes the current evidence for intentional weight loss treatments for HF in context.
Author	Horwich, Tamara B. Fonarow, Gregg C. Clark, Adrienne L.
Author_xml	– sequence: 1 givenname: Tamara B. surname: Horwich fullname: Horwich, Tamara B. email: thorwich@mednet.ucla.edu organization: David Geffen School of Medicine, University of California, Los Angeles, United States – sequence: 2 givenname: Gregg C. surname: Fonarow fullname: Fonarow, Gregg C. organization: David Geffen School of Medicine, University of California, Los Angeles, United States – sequence: 3 givenname: Adrienne L. surname: Clark fullname: Clark, Adrienne L. organization: Harvard Medical School, Boston, MA, United States
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/29852198$$D View this record in MEDLINE/PubMed
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Keywords	Heart failure Heart failure with preserved ejection fraction Body fat United States Cardiovascular disease Oxygen uptake Epicardial adipose tissue Right ventricle or ventricular Body mass index Waist circumference Bioelectrical impedance analysis Computed tomography Left ventricular ejection fraction Obesity paradox Cardiorespiratory fitness Minute ventilation/carbon dioxide production Dual energy x-ray absorptiometry Heart Failure with reduced ejection fraction
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SubjectTerms	Body mass index Heart failure Obesity paradox Waist circumference
Title	Obesity and the Obesity Paradox in Heart Failure
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