Issue 117 Item 8 Heart Failure Risk Doubled in Obese Versus Normal-Weight People

Increasing body mass index (BMI) is associated with increasing risk for heart failure that, from an analysis of data from the Framingham Heart study. As reported in the August 1st issue of The New England Journal of Medicine, Dr. Ramachandran S. Vasan from the Framingham Heart Study, Massachusetts, and colleagues investigated the relationship of BMI to incidence of heart failure in 5881 men and women who participated in the study.

During a mean followup of 14 years, 496 subjects developed heart failure. Among men, there was a 5% increase risk of heart failure for each increment of 1 in BMI. For women, the same increment in BMI was associated with a 7% increase in heart failure risk, the researchers found.

The hazard ratio for heart failure among obese subjects (BMI of 30.0 or more) compared with normal weight individuals was 1.90 in men and 2.12 in women, Dr. Vasan and colleagues report.

They add that "approximately 11% of cases of heart failure among men and 14% among women in the community are attributable to obesity alone."

Dr. Barry M. Massie from the Veterans Affairs Medical Center, San Francisco, comments in a journal editorial on the need to gather more data on the risk of cardiovascular events among obese and overweight patients.

"Recognition of the excessive risk of heart failure and other vascular events associated with overweight and obesity should lead to more frequent inclusion of overweight and obese patients in clinical trials, which would, in turn, help to identify additional therapies that may be particularly effective in preventing adverse cardiovascular outcomes in this population," he notes. N Engl J Med 2002;347:305-313,358-359.