Obesity across Heart Failure - Abstract
Obesity is a global pandemic of the 21st century. Prevalence in Europe has nearly tripled since the 1980s. In 2019, 52.7 % of the adult EU’s population was overweight and by 2025, 20% of the world population will be obese, with body mass index ?30kg/m2. Obesity is associated with an increased risk of developing heart failure (HF) as both direct and indirect effects of obesity contribute to development of HF. The risk of HF increased by 5% in men and 7% in women for every 1 kg/m2 increase in BMI and BMI higher than 30 kg/m2 doubled the incidence risk for development of heart failure. Ironically, despite proven increased health risks associated with obesity, many studies documented obesity paradox. Phenomenon, in which overweight and class I obese HF patients demonstrate a better prognosis compared with lean or underweight HF patients. This review provides present understanding of pathophysiological mechanisms contributing to the development of HF in obese people. Additionally, we discuss the existence of obesity survival paradox. Extant evidence supports this phenomenon and
numerous reasons and mechanisms for its existence have been postulated. However, emerging evidence disprove existence of obesity paradox, mostly based upon BMI, and many believe that no such phenomenon as obesity-survival paradox even exists, if only better ways of measuring body fat were used in initial studies. Finally, despite the obesity paradox, we address potential role of intentional weight reduction in the prevention and treatment of HF.