Higher BMI tied to more HF-related hospitalizations in patients with HFpEF
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Higher BMI was linked to greater risk for HF-related hospitalizations in patients with HF with preserved ejection fraction, regardless of age, sex and diabetes status, a speaker reported.
“Recent studies suggest that obesity and worsening obesity class may predict risk of heart failure hospitalizations among patients with HFpEF, but prior studies have been limited by lack of gender diversity, small sample sizes or short follow-up times,” Barry A. Borlaug, MD, of Mayo Clinic, said during the presentation at the American Heart Association Scientific Sessions.
In this retrospective, observational cohort study, researchers investigated the link between BMI and hospitalizations among patients with HFpEF and overweight/obesity.
Borlaug and colleagues extracted data on patients with BMI of at least 25 kg/m2 at the time of HFpEF diagnosis from a U.S. claims electronic medical record data set, then categorized patients into five BMI groups: overweight and obesity classes I to IV. They estimated the relationships between BMI, number of HF-related hospitalizations and risk for HFrelated hospitalization during follow-up, adjusting for relevant baseline comorbidities (with age, sex and diabetes status as effect modifiers).
Overall, the study included 4,975 patients. Higher BMI groups had a lower median age, fewer patients with CV history and more female patients compared with the overweight group.
The data showed that mean HF-related hospitalizations was greater in patients with higher BMI (effect of BMI: P = .002). On average, HF-related hospitalizations per 100 patient-years was greater for obesity class III (95% CI, 8.8-16.8) and class IV (95% CI, 10.9-22.4) compared with overweight (95% CI, 7.8-11.9). Compared with patients with overweight, the risk for HF-related hospitalization increased with each rise in obesity class (effect of BMI: P = .01; HR for obesity class III = 1.36; 95% CI, 0.97-1.91; HR for obesity class IV = 1.86; 95% CI, 1.32-2.64).
Borlaug noted that an important strength of this study was that it used a database drawn from real-world claims data, not from a clinical trial population.
“The observation that HFpEF exists in these patients, despite the presence of fewer cardiovascular diseases, suggests the possibility that greater obesity status is, in and of itself, more sufficient to cause the clinical syndrome of heart failure with preserved ejection fraction and, as such, treatments targeting adiposity may be more effective to treat and prevent heart failure in this setting,” Borlaug said.
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Morgen CS, et al. P380. Presented at: American Heart Association Scientific Sessions; Nov. 13-15, 2021 (virtual meeting).
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