Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2014;67:101-6 - Vol. 67 Num.02 DOI: 10.1016/j.rec.2013.06.022

Prognostic Value of Body Mass Index and Waist Circumference in Patients With Chronic Heart Failure (Spanish REDINSCOR Registry)

Teresa Puig a,, Andreu Ferrero-Gregori b, Eulalia Roig b, Rafael Vazquez c, Jose R. Gonzalez-Juanatey d, Domingo Pascual-Figal e, Juan Delgado f, Luis Alonso-Pulpon g, Xavier Borras b, Ana Mendez b, Juan Cinca b

a Servicio de Epidemiología Clínica, Hospital de la Santa Creu i Sant Pau, IIb-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
b Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIb-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
c Servicio de Cardiología, Hospital Puerta del Mar, Cádiz, Spain
d Servicio de Cardiología, Hospital Clínico, Santiago de Compostela, A Coruña, Spain
e Servicio de Cardiología, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain
f Servicio de Cardiología, Hospital 12 de Octubre, Madrid, Spain
g Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain

Keywords

Heart failure. Body mass index. Waist circumference. Obesity paradox. Prognosis. Multicenter study.

Abstract

Introduction and objectives

To analyze the association between higher body mass index and waist circumference, and the prognostic values of both indicators in total and cardiac mortality in patients with chronic heart failure.

Methods

The study included 2254 patients who were followed up for 4 years. Obesity was classified as a body mass index ≥30 and overweight as a body mass index of 25.0-29.9. Central obesity was defined as waist circumference ≥88 cm for women and ≥102 cm for men. Independent predictors of total and cardiac mortality were assessed in a multivariate Cox model adjusted for confounding variables.

Results

Obesity was present in 35% of patients, overweight in 43%, and central obesity in 60%. Body mass index and waist circumference were independent predictors of lower total mortality: hazard ratio =0.84 (P<.001) and hazard ratio = 0.97 (P=.01), respectively, and lower cardiac death (body mass index, hazard ratio =0.84, P<.001; waist circumference, hazard ratio =0.97, P=.01). The interaction between body mass index and waist circumference (hazard ratio =1.001, P<.01) showed that the protective effect of body mass index was lost in patients with a waist circumference >120 cm.

Conclusions

Mortality was significantly lower in patients with a high body mass index and waist circumference. The results also showed that this protection was lost when these indicators over a certain limit.

1885-5857/© 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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