Abstract
Introduction: Recent data show a relative increase of HFpEF in heart failure. Additionally, an increase in prevalence of obesity and metabolic syndrome (MetS) in the population have been reported. Obesity and MetS differ across race, ethnicity, and sex. We sought to examine characteristics of patients with HFpEF by both obesity and MetS status to characterize differences in patient profiles for HFpEF. Methods: We examined data from the Practice Innovation and Clinical Excellence (PINNACLE) Registry® (American College of Cardiology and Veradigm) for HFpEF patients (LVEF ≥ 50%) and receiving care in a cardiologist clinic from 2016 thru 2019. Obesity is defined as BMI ≥ 30 kg/m 2 and MetS is approximated among patients with no history of myocardial infarction by presence of three of the four conditions (dyslipidemia, hypertension, obesity, and diabetes) at baseline. Results: Among 218,843 HFpEF patients, 56.7% had obesity, 50.4% had MetS, 34.8% had neither, and 41.8% had both. Obese patients were younger than non-obese (69.9 vs 74.9 years) and MetS patients were somewhat younger than non-MetS (71.7 vs 72.5 years). Over half of non-obese (62.7%) and non-MetS (53.8%) patients were 80+ years old. A higher proportion of women were obese than non-obese (57.8 vs 47.3%), while the proportion of women with and without MetS was similar (54.7 and 54.1%). Blacks have higher proportions of both obese and MetS than without (9.8 vs 5.2% and 9.6 vs 6.5%). Hispanics also have a higher proportion of MetS than without (4.9 vs 3.9%). MetS group exhibited a higher rate of all other cardiovascular comorbidities than the obesity group except for atrial fibrilation. Conclusions: In this large cohort of HFpEF patients in the ambulatory specialist care setting, nearly 2/3 of the HFpEF patients had obesity or MetS. MetS patients reflect an older more minority population with a higher proportion of comorbidities than obese patients.
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