Update on Obesity and Obesity Paradox in Heart Failure

Prog Cardiovasc Dis. 2016 Jan-Feb;58(4):393-400. doi: 10.1016/j.pcad.2015.12.003. Epub 2015 Dec 23.


Obesity has reached epidemic proportions in most of the Westernized world. Overweightness and obesity adversely impact cardiac structure and function, including on both the right and, especially, left sides of the heart, with adverse affects on systolic and, especially, diastolic ventricular function. Therefore, it is not surprising that obesity markedly increases the prevalence of heart failure (HF). Nevertheless, many studies have documented an obesity paradox in large cohorts with HF, where overweight and obese have a better prognosis, at least in the short-term, compared with lean HF patients. Although weight loss clearly improves cardiac structure and function and reduces symptoms in HF, there are no large studies on the impact of weight loss on clinical events in HF, preventing definitive guidelines on optimal body composition in patients with HF.

Keywords: Fitness; Heart failure; Obesity.

Publication types

  • Review

MeSH terms

  • Body Mass Index
  • Heart Failure / complications*
  • Heart Failure / etiology
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Hemodynamics
  • Humans
  • Kaplan-Meier Estimate
  • Obesity / complications*
  • Overweight / complications
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / mortality
  • Ventricular Dysfunction, Left / physiopathology