Heart FailureMeta-Analysis of the Relation of Body Mass Index to All-Cause and Cardiovascular Mortality and Hospitalization in Patients With Chronic Heart Failure
Section snippets
Methods
A meta-analysis was performed in accordance with the Meta-Analysis of Observational Studies in Epidemiology guidelines.2 A checklist of each of these criteria and how they were handled in our study is contained in Supplementary Table 1.
We systematically searched PubMed, the Cumulative Index to Nursing and Allied Health Literature, Cochrane Central, Scopus, Embase and the Web of Science for all studies that reported total mortality, cardiac mortality, and rate of hospitalization on the basis of
Results
Six studies met the inclusion and exclusion criteria (n = 22,807) (Figure 1).3, 4, 5, 6, 7, 8 Follow-up duration ranged from 1.5 to 4.1 years. Details of the studies are listed in Table 1. Obese patients were younger than normal- and low-BMI patients on average by 4 and 7 years, respectively (Table 2).
The low-BMI group had the greatest risk for total mortality, with an RR of 1.27 (95% CI 1.17 to 1.37), while the overweight, obese, and severely obese groups had lower RRs of 0.78 (95% CI 0.68 to
Discussion
Our results indicate that in patients with chronic HF, the risk for all-cause and CV mortality and hospitalization was highest in those with low BMIs at the end of a mean follow-up period of 2.85 years and lowest in the overweight group. This finding is counterintuitive and supports the presumption of a strong obesity (or overweight) paradox (Figure 4).
Our results also show that unlike less severe degrees of obesity, which seem to be associated with an obesity paradox, severe obesity is
Disclosures
The authors have no conflicts of interest to disclose.
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