Being overweight may offer women a significant survival benefit from heart failure (HF), according to a study published Oct. 7 in JACC: Heart Failure.

In the analysis, Amanda R. Vest, MBBS, et al., studied 3,811 patients with left ventricular ejection fraction ≤40 percent who underwent cardiopulmonary exercise testing. Results showed that after a median follow-up of 6.2 years, there were 1,537 mortality events (40.3 percent crude mortality), and women had a lower crude mortality rate than men. After adjusting for confounders, the only group to experience a survival benefit was the overweight (but not obese) women. Overweight and obese men experienced increased adjusted mortality compared to normal weight men.

According to the authors, their research acknowledges “the importance of recognizing a non-linear relationship between body mass index (BMI) and mortality to permit detection of the differential effect of BMI on survival within different regions of the BMI spectrum.” They suggest that a greater understanding of why overweight women have a greater survival benefit may “reveal new therapeutic opportunities in advanced HF and also permit accurate counseling of HF patients regarding weight management.”

In an editorial comment, Carl J. Lavie, MD, FACC, and Hector O. Ventura, MD, FACC, write that “efforts are needed to increase physical activity in [cardiorespiratory fitness] throughout the health care system, including HF, as well as preventing obesity, especially more severe degrees of obesity…, in the prevention and treatment of [cardiovascular disease] and HF.” 

Keywords: Body Mass Index, Exercise Test, Follow-Up Studies, Heart Failure, Obesity, Overweight, Stroke Volume

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