The obesity paradox in heart failure patients with preserved versus reduced ejection fraction: a meta-analysis of individual patient data

Background: In heart failure (HF), obesity, defined as body mass index (BMI) ⩾30 kg m −2 , is paradoxically associated with higher survival rates compared with normal-weight patients (the ‘obesity paradox’). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fract...

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Published inInternational Journal of Obesity Vol. 38; no. 8; pp. 1110 - 1114
Main Authors Padwal, R, McAlister, F A, McMurray, J J V, Cowie, M R, Rich, M, Pocock, S, Swedberg, K, Maggioni, A, Gamble, G, Ariti, C, Earle, N, Whalley, G, Poppe, K K, Doughty, R N, Bayes-Genis, A
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 01.08.2014
Nature Publishing Group
Subjects
692/699/2743/393
692/699/75/230
692/700/139/2818
692/700/1750
Adult
Biological and medical sciences
Blood pressure
Body Mass Index
Body size
Cardiac output
Cardiology. Vascular system
Cardiovascular system
Clinical Medicine
Comorbidity
Confidence intervals
Congestive heart failure
Diabetes mellitus
Ejection fraction
Epidemiology
Etiology
Failure analysis
Female
Hazards
Health aspects
Health hazards
Health Promotion and Disease Prevention
Heart
Heart failure
Heart Failure - mortality
Heart Failure - physiopathology
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Hypertension
Internal Medicine
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
Ischemia
Klinisk medicin
Male
Medical sciences
Medicine
Medicine & Public Health
Meta-analysis
Metabolic Diseases
Mortality
Obesity
Obesity - complications
Obesity - mortality
original-article
Paradoxes
Patient outcomes
Patients
Physiological aspects
Prognosis
Proportional Hazards Models
Public Health
Risk Factors
Statistical models
Stroke Volume
Survival
Survival Analysis
Systematic review
Ventricle
heart failure
ejection fraction
obesity paradox
prognosis
body mass index
Medical data
Human
Heart failure
Obesity
Prognosis
Nutrition
Nutrition disorder
Cardiovascular disease
Patient
Metabolic diseases
Metaanalysis
Body mass index
Reduction
Heart disease
Hemodynamics
Nutritional status
Comparative study
Ejection fraction
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Abstract Background: In heart failure (HF), obesity, defined as body mass index (BMI) ⩾30 kg m −2 , is paradoxically associated with higher survival rates compared with normal-weight patients (the ‘obesity paradox’). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)). Patients and Methods: A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5–24.9 (referent), 25–29.9, 30–34.9 and ⩾35 kg m −2 . Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups. Results: BMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg m −2 , the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15–1.50) for BMI <22.5, 0.85 (0.76–0.96) for BMI 25.0–29.9, 0.64 (0.55–0.74) for BMI 30.0–34.9 and 0.95 (0.78–1.15) for BMI ⩾35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80–1.57) for BMI <22.5, 0.74 (0.56–0.97) for BMI 25.0–29.9, 0.64 (0.46–0.88) for BMI 30.0–34.9 and 0.71 (0.49–1.05) for BMI ⩾35. Conclusions: In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0–34.9 kg m −2 .
AbstractList BACKGROUND: In heart failure (HF), obesity, defined as body mass index (BMI) ≥ 30kg [m.sup.-2], is paradoxically associated with higher survival rates compared with normal-weight patients (the 'obesity paradox'). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF- PEF)). PATIENTS AND METHODS: A sub-analysis of the MAGGIC meta-analysis of patient- level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5-24.9 (referent), 25-29.9, 30-34.9 and ≥ 35 kg [m.sup.-2]. Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non- ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups. RESULTS: BMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg [m.sup.-2], the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR) = 1.31 (95% confidence interval = 1.15-1.50) for BMI <22.5, 0.85 (0.76-0.96) for BMI 25.0-29.9, 0.64 (0.55-0.74) for BMI 30.0-34.9 and 0.95 (0.78-1.15) for BMI ≥ 35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval = 0.80-1.57) for BMI <22.5, 0.74 (0.56-0.97) for BMI 25.0- 29.9, 0.64 (0.46-0.88) for BMI 30.0-34.9 and 0.71 (0.49-1.05) for BMI [greater than or equal to] 35. CONCLUSIONS: In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0-34.9 kg [m.sup.-2]. International Journal of Obesity (2014) 38, 1110-1114; doi: 10.1038/ijo.2013.203 Keywords: body mass index; heart failure; prognosis; obesity paradox; ejection fraction
In heart failure (HF), obesity, defined as body mass index (BMI) ≥30kgm(-2), is paradoxically associated with higher survival rates compared with normal-weight patients (the 'obesity paradox'). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)). A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5-24.9 (referent), 25-29.9, 30-34.9 and ≥35kgm(-2). Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups. BMI data were available for 23967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9kgm(-2), the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15-1.50) for BMI <22.5, 0.85 (0.76-0.96) for BMI 25.0-29.9, 0.64 (0.55-0.74) for BMI 30.0-34.9 and 0.95 (0.78-1.15) for BMI ≥35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80-1.57) for BMI <22.5, 0.74 (0.56-0.97) for BMI 25.0-29.9, 0.64 (0.46-0.88) for BMI 30.0-34.9 and 0.71 (0.49-1.05) for BMI ≥35. In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0-34.9kgm(-2).
In heart failure (HF), obesity, defined as body mass index (BMI) ≥30 kg m(-2), is paradoxically associated with higher survival rates compared with normal-weight patients (the 'obesity paradox'). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)). A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5-24.9 (referent), 25-29.9, 30-34.9 and ≥35 kg m(-2). Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups. BMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg m(-2), the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15-1.50) for BMI <22.5, 0.85 (0.76-0.96) for BMI 25.0-29.9, 0.64 (0.55-0.74) for BMI 30.0-34.9 and 0.95 (0.78-1.15) for BMI ≥35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80-1.57) for BMI <22.5, 0.74 (0.56-0.97) for BMI 25.0-29.9, 0.64 (0.46-0.88) for BMI 30.0-34.9 and 0.71 (0.49-1.05) for BMI ≥35. In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0-34.9 kg m(-2).
Background:In heart failure (HF), obesity, defined as body mass index (BMI) ⩾30 kg m−2, is paradoxically associated with higher survival rates compared with normal-weight patients (the ‘obesity paradox’). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)).Patients and Methods:A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5–24.9 (referent), 25–29.9, 30–34.9 and ⩾35 kg m−2. Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups.Results:BMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg m−2, the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15–1.50) for BMI <22.5, 0.85 (0.76–0.96) for BMI 25.0–29.9, 0.64 (0.55–0.74) for BMI 30.0–34.9 and 0.95 (0.78–1.15) for BMI ⩾35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80–1.57) for BMI <22.5, 0.74 (0.56–0.97) for BMI 25.0–29.9, 0.64 (0.46–0.88) for BMI 30.0–34.9 and 0.71 (0.49–1.05) for BMI ⩾35.Conclusions:In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0–34.9 kg m−2.
International Journal of Obesity (2014) 38, 1110-1114; doi: 10.1038/ijo.2013.203
Background: In heart failure (HF), obesity, defined as body mass index (BMI) ⩾30 kg m −2 , is paradoxically associated with higher survival rates compared with normal-weight patients (the ‘obesity paradox’). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)). Patients and Methods: A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5–24.9 (referent), 25–29.9, 30–34.9 and ⩾35 kg m −2 . Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups. Results: BMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg m −2 , the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15–1.50) for BMI <22.5, 0.85 (0.76–0.96) for BMI 25.0–29.9, 0.64 (0.55–0.74) for BMI 30.0–34.9 and 0.95 (0.78–1.15) for BMI ⩾35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80–1.57) for BMI <22.5, 0.74 (0.56–0.97) for BMI 25.0–29.9, 0.64 (0.46–0.88) for BMI 30.0–34.9 and 0.71 (0.49–1.05) for BMI ⩾35. Conclusions: In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0–34.9 kg m −2 .
Background: In heart failure (HF), obesity, defined as body mass index (BMI) [egs]30 kg m super(-2), is paradoxically associated with higher survival rates compared with normal-weight patients (the 'obesity paradox'). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)).Patients and Methods: A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5-24.9 (referent), 25-29.9, 30-34.9 and [egs]35 kg m super(-2). Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups. Results: BMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg m super(-2), the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15-1.50) for BMI <22.5, 0.85 (0.76-0.96) for BMI 25.0-29.9, 0.64 (0.55-0.74) for BMI 30.0-34.9 and 0.95 (0.78-1.15) for BMI [egs]35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80-1.57) for BMI <22.5, 0.74 (0.56-0.97) for BMI 25.0-29.9, 0.64 (0.46-0.88) for BMI 30.0-34.9 and 0.71 (0.49-1.05) for BMI [egs]35. Conclusions: In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0-34.9 kg m super(-2).
Background:In heart failure (HF), obesity, defined as body mass index (BMI) >/=30 kg m-2, is paradoxically associated with higher survival rates compared with normal-weight patients (the 'obesity paradox'). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)).Patients and Methods:A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5-24.9 (referent), 25-29.9, 30-34.9 and >/=35 kg m-2. Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups.Results:BMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg m-2, the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15-1.50) for BMI <22.5, 0.85 (0.76-0.96) for BMI 25.0-29.9, 0.64 (0.55-0.74) for BMI 30.0-34.9 and 0.95 (0.78-1.15) for BMI >/=35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80-1.57) for BMI <22.5, 0.74 (0.56-0.97) for BMI 25.0-29.9, 0.64 (0.46-0.88) for BMI 30.0-34.9 and 0.71 (0.49-1.05) for BMI >/=35.Conclusions:In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0-34.9 kg m-2.International Journal of Obesity advance online publication, 26 November 2013; doi:10.1038/ijo.2013.203.
In heart failure (HF), obesity, defined as body mass index (BMI) ≥30 kg m(-2), is paradoxically associated with higher survival rates compared with normal-weight patients (the 'obesity paradox'). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)).BACKGROUNDIn heart failure (HF), obesity, defined as body mass index (BMI) ≥30 kg m(-2), is paradoxically associated with higher survival rates compared with normal-weight patients (the 'obesity paradox'). We sought to determine if the obesity paradox differed by HF subtype (reduced ejection fraction (HF-REF) versus preserved ejection fraction (HF-PEF)).A sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5-24.9 (referent), 25-29.9, 30-34.9 and ≥35 kg m(-2). Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups.PATIENTS AND METHODSA sub-analysis of the MAGGIC meta-analysis of patient-level data from 14 HF studies was performed. Subjects were divided into five BMI groups: <22.5, 22.5-24.9 (referent), 25-29.9, 30-34.9 and ≥35 kg m(-2). Cox proportional hazards models adjusted for age, sex, aetiology (ischaemic or non-ischaemic), hypertension, diabetes and baseline blood pressure, stratified by study, were used to examine the independent association between BMI and 3-year total mortality. Analyses were conducted for the overall group and within HF-REF and HF-PEF groups.BMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg m(-2), the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15-1.50) for BMI <22.5, 0.85 (0.76-0.96) for BMI 25.0-29.9, 0.64 (0.55-0.74) for BMI 30.0-34.9 and 0.95 (0.78-1.15) for BMI ≥35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80-1.57) for BMI <22.5, 0.74 (0.56-0.97) for BMI 25.0-29.9, 0.64 (0.46-0.88) for BMI 30.0-34.9 and 0.71 (0.49-1.05) for BMI ≥35.RESULTSBMI data were available for 23 967 subjects (mean age, 66.8 years; 32% women; 46% NYHA Class II; 50% Class III) and 5609 (23%) died by 3 years. Obese patients were younger, more likely to receive cardiovascular (CV) drug treatment, and had higher comorbidity burdens. Compared with BMI levels between 22.5 and 24.9 kg m(-2), the adjusted relative hazards for 3-year mortality in subjects with HF-REF were: hazard ratios (HR)=1.31 (95% confidence interval=1.15-1.50) for BMI <22.5, 0.85 (0.76-0.96) for BMI 25.0-29.9, 0.64 (0.55-0.74) for BMI 30.0-34.9 and 0.95 (0.78-1.15) for BMI ≥35. Corresponding adjusted HRs for those with HF-PEF were: 1.12 (95% confidence interval=0.80-1.57) for BMI <22.5, 0.74 (0.56-0.97) for BMI 25.0-29.9, 0.64 (0.46-0.88) for BMI 30.0-34.9 and 0.71 (0.49-1.05) for BMI ≥35.In patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0-34.9 kg m(-2).CONCLUSIONSIn patients with chronic HF, the obesity paradox was present in both those with reduced and preserved ventricular systolic function. Mortality in both HF subtypes was U-shaped, with a nadir at 30.0-34.9 kg m(-2).
Audience Academic
Author Gamble, G
Whalley, G
Doughty, R N
McAlister, F A
Swedberg, K
Maggioni, A
Poppe, K K
Cowie, M R
Pocock, S
Ariti, C
Padwal, R
Rich, M
McMurray, J J V
Bayes-Genis, A
Earle, N
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  givenname: R
  surname: Padwal
  fullname: Padwal, R
  email: rpadwal@ualberta.ca
  organization: Department of Medicine, University of Alberta
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  givenname: F A
  surname: McAlister
  fullname: McAlister, F A
  organization: Department of Medicine, University of Alberta
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  givenname: J J V
  surname: McMurray
  fullname: McMurray, J J V
  organization: BHF Cardiovascular Research Centre, University of Glasgow
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  givenname: M R
  surname: Cowie
  fullname: Cowie, M R
  organization: Faculty of Medicine, National Heart and Lung Institute, Imperial College London (Royal Brompton Hospital)
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  surname: Rich
  fullname: Rich, M
  organization: Washington University School of Medicine
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  surname: Pocock
  fullname: Pocock, S
  organization: Department of Medical Statistics, London School of Hygiene and Tropical Medicine
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  givenname: K
  surname: Swedberg
  fullname: Swedberg, K
  organization: Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, University of Gothenburg
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  surname: Maggioni
  fullname: Maggioni, A
  organization: ANMCO Research Center
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  givenname: G
  surname: Gamble
  fullname: Gamble, G
  organization: Department of Medicine and National Institute for Health Innovation, University of Auckland
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  givenname: C
  surname: Ariti
  fullname: Ariti, C
  organization: Department of Medical Statistics, London School of Hygiene and Tropical Medicine
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  givenname: N
  surname: Earle
  fullname: Earle, N
  organization: Department of Medicine and National Institute for Health Innovation, University of Auckland
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  surname: Whalley
  fullname: Whalley, G
  organization: Faculty of Social and Health Sciences, UNITEC Institute of Technology
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  surname: Poppe
  fullname: Poppe, K K
  organization: Department of Medicine and National Institute for Health Innovation, University of Auckland
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  givenname: R N
  surname: Doughty
  fullname: Doughty, R N
  organization: Department of Medicine and National Institute for Health Innovation, University of Auckland
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  givenname: A
  surname: Bayes-Genis
  fullname: Bayes-Genis, A
  organization: Department of Medicine, Hospital Universitari Germans Trias i Pujol UAB
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ContentType Journal Article
Contributor Brett, M
Taffet, G
Ezekowitz, J
Yusuf, S
Doughty, R N
Gotsman, I
Martínez-Sellés, M
Lenzen, M
Scholte op Reimer, W J M
Pocock, S
Richards, M
McMurray, J J V
Poppe, K
Massie, B
Grigorian-Shamagian, L
Azaz-Livshits, T
Squire, I
Granger, C B
Tarantini, L
Dobson, J
Gonzalez-Juanatey, J
di Lenarda, A
Varela-Roman, A
Swedberg, K
Zwas, D
Admon, D
Lucci, D
Hogg, K
Køber, L
Lainchbury, J
Kearney, M
Tribouilloy, C
Bayes-Genis, A
Hall, C
Torp-Pedersen, C
Doughty, R
Andersson, B
Richards, A M
Vantrimpont, P J M J
Whalley, G
Senni, M
Pfeffer, M A
Planer, D
Oliva, F
Ahmed, Ali
Gorini, M
Rich, M
Guazzi, M
Lotan, C
Tsutsui, H
Keren, A
Earle, N
Held, P
McAlister, F
Cleland, J
Michelson, E L
Gamble, G D
Boersma, E
Östergren, J
McMurray, J
Somaratne, J
Granger, C
Maggioni, A
Stevenson, K
Lenzen, M J
Berry, C
Ariti, C
Olofsson, B
Cubbon, R
Troughton, R
Komajda, M
Madsen, B
Norrie, J
Macı, S
Ahmed, A
Cowie, M
Follath, F
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Copyright Macmillan Publishers Limited 2014
2015 INIST-CNRS
COPYRIGHT 2014 Nature Publishing Group
Copyright Nature Publishing Group Aug 2014
Macmillan Publishers Limited 2014.
Copyright_xml – notice: Macmillan Publishers Limited 2014
– notice: 2015 INIST-CNRS
– notice: COPYRIGHT 2014 Nature Publishing Group
– notice: Copyright Nature Publishing Group Aug 2014
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CorporateAuthor for the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) Investigators
Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)
CorporateAuthor_xml – name: for the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) Investigators
– name: Meta-analysis Global Group in Chronic Heart Failure (MAGGIC)
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IsPeerReviewed true
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Issue 8
Keywords heart failure
ejection fraction
obesity paradox
prognosis
body mass index
Medical data
Human
Heart failure
Obesity
Prognosis
Nutrition
Nutrition disorder
Cardiovascular disease
Patient
Metabolic diseases
Metaanalysis
Body mass index
Reduction
Heart disease
Hemodynamics
Nutritional status
Comparative study
Ejection fraction
Language English
License CC BY 4.0
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PublicationTitle International Journal of Obesity
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Snippet Background: In heart failure (HF), obesity, defined as body mass index (BMI) ⩾30 kg m −2 , is paradoxically associated with higher survival rates compared with...
In heart failure (HF), obesity, defined as body mass index (BMI) ≥30 kg m(-2), is paradoxically associated with higher survival rates compared with...
BACKGROUND: In heart failure (HF), obesity, defined as body mass index (BMI) ≥ 30kg [m.sup.-2], is paradoxically associated with higher survival rates compared...
International Journal of Obesity (2014) 38, 1110-1114; doi: 10.1038/ijo.2013.203
In heart failure (HF), obesity, defined as body mass index (BMI) ≥30kgm(-2), is paradoxically associated with higher survival rates compared with normal-weight...
Background:In heart failure (HF), obesity, defined as body mass index (BMI) ⩾30 kg m−2, is paradoxically associated with higher survival rates compared with...
Background: In heart failure (HF), obesity, defined as body mass index (BMI) [egs]30 kg m super(-2), is paradoxically associated with higher survival rates...
Background:In heart failure (HF), obesity, defined as body mass index (BMI) >/=30 kg m-2, is paradoxically associated with higher survival rates compared with...
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SubjectTerms 692/699/2743/393
692/699/75/230
692/700/139/2818
692/700/1750
Adult
Biological and medical sciences
Blood pressure
Body Mass Index
Body size
Cardiac output
Cardiology. Vascular system
Cardiovascular system
Clinical Medicine
Comorbidity
Confidence intervals
Congestive heart failure
Diabetes mellitus
Ejection fraction
Epidemiology
Etiology
Failure analysis
Female
Hazards
Health aspects
Health hazards
Health Promotion and Disease Prevention
Heart
Heart failure
Heart Failure - mortality
Heart Failure - physiopathology
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Hypertension
Internal Medicine
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
Ischemia
Klinisk medicin
Male
Medical sciences
Medicine
Medicine & Public Health
Meta-analysis
Metabolic Diseases
Mortality
Obesity
Obesity - complications
Obesity - mortality
original-article
Paradoxes
Patient outcomes
Patients
Physiological aspects
Prognosis
Proportional Hazards Models
Public Health
Risk Factors
Statistical models
Stroke Volume
Survival
Survival Analysis
Systematic review
Ventricle
Title The obesity paradox in heart failure patients with preserved versus reduced ejection fraction: a meta-analysis of individual patient data
URI https://link.springer.com/article/10.1038/ijo.2013.203
https://www.ncbi.nlm.nih.gov/pubmed/24173404
https://www.proquest.com/docview/1551138550
https://www.proquest.com/docview/2639126616
https://www.proquest.com/docview/1551611763
https://www.proquest.com/docview/1680438485
https://gup.ub.gu.se/publication/189074
Volume 38
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