Clinical InvestigationCongestive Heart FailureAn obesity paradox in acute heart failure: Analysis of body mass index and inhospital mortality for 108 927 patients in the Acute Decompensated Heart Failure National Registry
Section snippets
Methods
The ADHERE is a national observational registry of hospital data on patients admitted with HF.16 Its design as well as methods and the characteristics of patients included in the ADHERE have been described previously.16 Briefly, medical records are retrospectively reviewed at participating sites by the research coordinator and data from consecutive eligible male and female patients ≥18 years at the time of hospital admission are electronically entered into the registry.16 These data include
Results
From October 2001 through December 2004, there were 155 073 acute HF hospitalization episodes in the ADHERE. Of the patients involved, 46 146 (30%) were excluded from analysis because of missing data on height, weight, or both. Thus, 108 927 acute HF hospitalization episodes of patients with documented height and admission weight were available for analysis. Baseline characteristics between patients with BMI data and those with missing BMI data were similar or showed only modest differences (mean
Discussion
This study demonstrates that increased BMI is associated with a significantly lower risk for inhospital mortality among patients hospitalized with acute HF. This relationship was independent of other known prognostic factors and persisted in hospitalized patients with HF who have both reduced and preserved systolic function. By weight category, patients who were overweight and obese had mortality risks that were 26.1% and 47.8%, respectively, lower as compared with the mortality risk of healthy
References (29)
- et al.
Risk factors for heart failure in the elderly: a prospective community-based study
Am J Med
(1999) Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome
Am J Med Sci
(2001)- et al.
The relationship between obesity and mortality in patients with heart failure
J Am Coll Cardiol
(2001) - et al.
Body composition and prognosis in chronic systolic heart failure: the obesity paradox
Am J Cardiol
(2003) - et al.
The prognostic value of body mass index and standard exercise testing in male veterans with congestive heart failure
J Card Fail
(2002) - et al.
Body mass and survival in patients with chronic heart failure without cachexia: the importance of obesity
J Card Fail
(2003) - et al.
Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE)
Am Heart J
(2005) - et al.
In-hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications: an analysis from the Acute Decompensated Heart Failure National Registry (ADHERE)
J Am Coll Cardiol
(2005) - et al.
Metabolic and nutritional disorders in cardiac cachexia
Nutrition
(2001) - et al.
Cardiac cachexia: a syndrome with impaired survival and immune and neuroendocrine activation
Chest
(1999)
The endotoxin-lipoprotein hypothesis
Lancet
Contrasting clinical properties and exercise responses in obese and lean hypertensive patients
J Am Coll Cardiol
Elevated body mass index and intermediate-term clinical outcomes after acute coronary syndromes
Am J Med
The prognostic importance of body mass index after complicated myocardial infarction
J Am Coll Cardiol
Cited by (411)
Clinical Implication of N-Terminal Pro-Brain Natriuretic Peptide Burden in Heart Failure With Reduced Ejection Fraction: From the GUIDE-IT
2024, American Journal of CardiologyThe association between body mass index and mortality in septic older adults
2023, Geriatric NursingLong-term outcome in pulmonary embolism: Is it healthy to be lean?
2023, European Journal of Internal MedicineUpdates on obesity and the obesity paradox in cardiovascular diseases
2023, Progress in Cardiovascular Diseases
The Acute Decompensated Heart Failure National Registry and this study were funded by Scios, Inc (Freemont, CA).