Body habitus in heart failure: understanding the mechanisms and clinical significance of the obesity paradox

Future Cardiol. 2016 Nov;12(6):639-653. doi: 10.2217/fca-2016-0029. Epub 2016 Oct 20.


The prevalence of obesity among adults and children worldwide has reached epic proportions and has become a major independent risk factor for the development of heart failure (HF), in addition to a contributor of hypertension and cardiovascular disease. The implications of obesity in the development of HF involve adverse effects on cardiac structure and function. Despite all of this, in the setting of chronic HF, excess body mass is associated with improved clinical outcomes, demonstrating the presence of an obesity paradox. In this review, we will discuss the gender differences, global application, potential mechanisms and role of interventions based on fitness and purposeful weight loss as potential therapeutic strategies.

Keywords: BMI; HTN; body habitus; cardiorespiratory fitness; gender; heart failure; obesity; obesity paradox; weight loss.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Body Mass Index*
  • Child
  • Female
  • Heart Failure / etiology*
  • Humans
  • Male
  • Obesity / complications*
  • Obesity / therapy
  • Prognosis
  • Risk Factors
  • Sex Factors
  • Weight Loss