Need another reason to work out?™ "...heart failure incidence and prevalence, not surprisingly, is markedly increased in obese patients."

JACC Heart Fail. 2013 Apr;1(2):93-102. doi: 10.1016/j.jchf.2013.01.006. Epub 2013 Apr 1.

Impact of Obesity and the Obesity Paradox on Prevalence and Prognosis in Heart Failure.

Lavie CJ1, Alpert MA2, Arena R3, Mehra MR4, Milani RV5, Ventura HO5.

Author information

• 1Department of Cardiovascular Diseases, John Ochsner Heart & Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana; Department of Preventive Medicine, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana. Electronic address: clavie@ochsner.org.
• 2Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri.
• 3Division of Physical Therapy, Department of Orthopaedics and Rehabilitation and Division of Cardiology, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico.
• 4Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
• 5Department of Cardiovascular Diseases, John Ochsner Heart & Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, Louisiana.

Abstract

Obesity has reached epidemic proportions in the United States and worldwide. Considering the adverse effects of obesity on left ventricular (LV) structure, diastolic and systolic function, and other risk factors for heart failure (HF), including hypertension and coronary heart disease, HF incidence and prevalence, not surprisingly, is markedly increased in obese patients. Nevertheless, as with most other cardiovascular diseases, numerous studies have documented an obesity paradox, in which overweight and obese patients, defined by body mass index, percent body fat, or centralobesity, demonstrate a better prognosis compared with lean or underweight HF patients. This review will describe the data on obesity in the context of cardiopulmonary exercise testing in HF. Additionally, the implications of obesity on LV assist devices and heart transplantation are reviewed. Finally, despite the obesity paradox, we address the current state of weight reduction in HF.