The Obesity Paradox in Chronic Heart Failure: What Does It Mean?

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• 作者：Paul J. Chase (1) (2)
  Paul G. Davis (2)
  Daniel R. Bensimhon (1) (3)
  
• 关键词：Obesity paradox ; Body mass index ; Heart failure ; Cardiorespiratory fitness ; Total fitness ; Body fat distribution ; Weight management
• 刊名：Current Heart Failure Reports
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：11
• 期：1
• 页码：111-117
• 全文大小：195 KB
• 作者单位：Paul J. Chase (1) (2)
  Paul G. Davis (2)
  Daniel R. Bensimhon (1) (3)
  
  1. LeBauer Cardiovascular Research Foundation, Cone Health, 1200 N. Elm St, Greensboro, NC, 27401, USA
  2. Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
  3. Advanced Heart Failure Clinic, Cone Health, 1200 N. Elm St., Greensboro, NC, 27401, USA
  
• ISSN：1546-9549

文摘

Heart failure (HF) is a growing health problem, at least in part due to the concurrent obesity epidemic plaguing developed countries. However, once a patient develops HF, an elevated BMI appears to confer a survival benefit -a phenomenon termed the “obesity paradox.-The exact explanation for this paradox has been difficult to ascertain. Numerous plausible mechanisms have been asserted, including the fact that obese patients tend to be younger and more symptomatic, leading them to seek medical attention earlier in the course of their HF. Obese patients may also have larger energy reserves that help to offset the catabolic changes seen with HF. Other hypotheses highlight the limitations of BMI as an obesity classifier. The purpose of this review is to examine the various theories for the obesity paradox in HF and discuss the implications for the clinical management of obese patients with HF.