Body Habitus in Heart Failure: Understanding the Mechanisms and Clinical Significance of the Obesity Paradox

Abstract

The prevalence of obesity among adults and children worldwide has reached epic proportions and has become a major independent risk factor for the development of heart failure (HF), in addition to a contributor of hypertension and cardiovascular disease. The implications of obesity in the development of HF involve adverse effects on cardiac structure and function. Despite all of this, in the setting of chronic HF, excess body mass is associated with improved clinical outcomes, demonstrating the presence of an obesity paradox. In this review, we will discuss the gender differences, global application, potential mechanisms and role of interventions based on fitness and purposeful weight loss as potential therapeutic strategies.

KEYWORDS :

• body habitus
• BMI
• cardiorespiratory fitness
• gender
• heart failure
• HTN
• obesity
• obesity paradox
• weight loss

Financial & competing interests disclosure

CJ Lavie has lectured for the Coca Cola Company (but on exercise, fitness and obesity and not on their products) and he is the author of the book, The Obesity Paradox. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

LV: Left ventricular; RV: Right ventricular.

Reproduced with permission from Lavie et al. [33].

† Caused by lower atrial natriuretic peptide levels, restrictive lung disease, venous insufficiency and so on.

Reproduced with permission from Lavie et al. [7].