OBESITY PARADOX AND HYPERTENSION: NEW INSIGHTS IN HEART FAILURE PATIENTS

Abstract

Objective: Heart failure (HF) is more prevalent among obese and overweight individuals than among normal weight people, although there is a survival advantage for obese and overweight patients compared with normal weight or low weight patients, the so-called obesity paradox in HF. On the other hand, obesity increases the risk of hypertension and the relationship between HF and hypertension is well-established; however, the prognostic role of obesity has not been investigated sufficiently in hypertensive HF patients. Design and method: Patients with HF were evaluated in a cross sectional study. Office blood pressure (BP), both systolic (SBP) and diastolic (DBP), the duration in years from the first diagnosis of hypertension and body mass index (BMI) were recorded as well. The prognostic role of obesity was evaluated according to the number of hospitalizations for HF in the last six months and in the last year. Results: A total of 306 consecutive male patients with HF participated in the study. Overweight were 45,8%, obese 37,2% and normal weight 16,9% of patients according to BMI. Both SBP and DBP had a negative correlation with the number of hospitalizations for HF in the last six months and in the last year (r = -0.174, p = 0.008, r = -0.190, p = 0.004 for systolic, and r = -0,130, p = 0.049, r = -0.155 and p = 0.018 for diastolic, respectively). Overweight, obese and lean participants did not differ in BP, both SBP and DBP, and in their HF morbidity according to hospitalizations (p = 0.075, p = 0.271, and p = 0.407, respectively). Patients with hypertension had higher values of BMI (p = 0.032), but office SBP and DBP did not have any correlation with BMI. Also, BMI did not differ among patients with or without hypertension, and although BMI had a negative correlation with the number of hospitalization for HF, that was not significant (r = -0.062, p = 0.346). Conclusions: Our study provides some new insights regarding to the relationship between obesity and office BP in HF patients. Obese is highly prevalent in HF patients with or without hypertension, but the association between BMI and morbidity according to the number of hospitalizations has not been found to be significant in hypertensive patients.