Heart failure risk linked with obesity, inflammatory proteins

Results from the MESA study demonstrated that obesity and prolonged inflammation were associated with congestive heart failure.

Researchers from Johns Hopkins, University of Washington, Seattle, and other large U.S. institutions studied these associations in 6,814 white, black, Hispanic and Chinese-American participants aged 45 to 84 years.

During four years of follow-up, 79 participants developed CHF and 35 (44%) were obese with a body mass index ≥30. Twenty-six participants (32.9%) had a myocardial infarction prior to CHF and 65% had CHF with preserved function. Notably, all participants were free from a previous history of heart disease.

Multivariate analysis revealed that serum interleukin-6, C-reactive protein and microalbuminuria were independent predictors of CHF. Interleukin-6 levels were nearly twice as high in obese individuals and accounted for an 84% greater risk for developing CHF. C-reactive protein levels were three times higher in obese vs. normal-weight individuals and increased the risk for CHF by 36%. Fibrinogen levels were also one-fifth higher in obese individuals and increased the risk by 37%.

When inflammatory protein levels were included in the statistical analysis, the heightened risk from obesity disappeared.

The link between obesity and CHF may be linked to pathophysiologic pathways associated with inflammation, according to the researchers. Careful monitoring of obese patients for early signs of inflammation in the heart is warranted, they wrote.

All MESA study participants will be followed through 2012. The study is funded by the National Heart, Lung and Blood Institute. – by Katie Kalvaitis

J Am Coll Cardiol. 2008;51:1775-1783.