Abstract P167: Association Between Obesity and New-Onset Heart Failure Among People With Hypertension in Thailand

Abstract

Obesity establishes cardiovascular risk factors, including high blood pressure, hyperlipidemia, and high blood glucose, and also results in cardiovascular events. In Thailand, the epidemiological data on the relationship between obesity and heart failure (HF) among high-risk populations was limited. We assessed the hypothesis that increased body mass index (BMI) was associated with the new-onset HF among people with hypertension (HTN); we also assessed the effect modifier of uncontrolled HTN on this association. We conducted a retrospective cohort study in 2018. Thai people with HTN aged 20 years and older receiving continuous care at out patient clinic in the hospitals nationwide were included. While those with a history of HF before 12 months from the data collection date were excluded. The new-onset HF was defined regarding the ICD-10 as I50 in the medical records within 12 months. The information on the characteristics and BMI of participants was extracted from the medical records by well-trained registered nurses. Obesity was defined as BMI ≥25 kg/m 2 . We performed multivariable log-binomial regression analysis to determine the association between BMI and new-onset HF and presented as the adjusted risk ratio (aRR) and 95%CI. A total of 35,756 participants were included in the analysis. The mean age of participants was 64.5±0.1 years. In all, 61.4% were women, and 50.0% had controlled HTN (SBP<140 mmHg and DBP <90 mmHg) two visits consecutively. The mean BMI was 25.1±0.02 kg/m 2 . New-onset HF occurred in 75 participants (0.21%). Adjusting for age, sex, health schemes, geographic regions, hospital types, type 2 diabetes, dyslipidemia, renal insufficiency, history of ischemic heart disease, smoking status, alcohol use, uncontrolled HTN, and ACEI/ARB use, increased BMI per 1 kg/m 2 was significantly associated with new-onset HF (aRR 1.09 [95%CI: 1.05-1.14]). In comparison with participants with BMI of 18.5-22.9 kg/m 2 , the aRR for new-onset HF was 1.57 (95% CI:0.80-3.08), 3.69 (95%CI: 1.73-7.87), and 5.18 (95% CI: 1.81-14.81) in those with BMI 25.0-29.9, 30.0-34.9, and ≥35.0 kg/m 2 , respectively. For participants with obesity, aRR for new-onset HF was 2.05 (95% CI: 1.24-3.39) compared to non-obese participants. The effect modification of uncontrolled HTN on the association between obesity and new-onset HF was not observed ( p -value = 0.641). In conclusion, an increased BMI had a higher risk for new-onset HF among Thai people with HTN. Obesity was independently associated with new-onset HF among people with HT, regardless of uncontrolled HTN.