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Body mass index, prognosis and mode of death in chronic heart failure: Results from the Valsartan Heart Failure Trial
Author(s) -
Cicoira Mariantonietta,
Maggioni Aldo Pietro,
Latini Roberto,
Barlera Simona,
Carretta Elisa,
Janosi Andras,
Soler Jordi Soler,
Anand Inder,
Cohn Jay N.
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2006.10.016
Subject(s) - medicine , underweight , heart failure , overweight , body mass index , obesity paradox , cardiology , valsartan , obesity , blood pressure
Aims: To assess the relationship between body mass index (BMI), mortality and mode of death in chronic heart failure (CHF) patients; to define the shape of the relationship between BMI and mortality. Methods and results: We performed a post‐hoc analysis of 5010 patients from the Valsartan Heart Failure Trial. The end‐points of the study were all‐cause and cardiovascular mortality. Mortality rate was 27.2% in underweight patients (BMI<22 kg/m 2 ), 21.7% in normal weight patients (BMI 22–24.9 kg/m 2 ), 17.9% in overweight patients (BMI 25–29.9 kg/m 2 ) and 16.5% in obese patients (BMI>30 kg/m 2 ) ( p <0.0001). The rates of non‐cardiovascular death did not differ among groups. The risk of death due to progressive heart failure was 3.4‐fold higher in the underweight than in the obese patients ( p <0.0001). Normal weight, overweight and obese patients had lower risk of death as compared with underweight patients ( p =0.019, HR 0.76, 95% CI 0.61–0.96; p =0.0005, HR 0.68, 95% CI 0.55–0.84; p =0.003, HR 0.67, 95% CI 0.52–0.88, respectively) independently of symptoms, ventricular function, beta‐blocker use, C‐reactive protein and brain natriuretic peptide levels. Conclusions: In CHF patients a higher BMI is associated with a better prognosis independently of other clinical variables. The relationship between mortality and BMI is monotonically decreasing.