Obese heart failure patients fare better than lean

Although obesity is usually linked to detrimental health consequences, new research indicates that overweight people with heart failure have a lower mortality risk than those of normal weight.

This is not the first study to describe a protective effect for obesity in heart failure patients, senior author Dr. Harlan M. Krumholz and colleagues, from Yale University School of Medicine in New Haven, Connecticut, note. However, past studies were typically small in size and focused on patients with severe heart failure, mostly ignoring the larger population of outpatients with a less severe condition.

The current study, which is reported in the Archives of Internal Medicine, involved 7767 patients with stable heart failure who were followed for an average of three years. Using standard definitions, the patients were divided into four groups: underweight, healthy weight, overweight and obese.

During the follow-up period, obese and overweight patients were 19 percent and 12 percent less likely to die, respectively, than healthy weight patients. By contrast, underweight patients were 21 percent more likely to die than their healthy weight peers.

As to why obesity is linked to better outcomes in heart failure patients, the authors speculate it may be because weight-related problems cause them to be diagnosed at an earlier stage.

So what does this mean for overweight or obese heart failure patients? Until further data are available, the findings suggest that they shouldn't try to lose weight, the report states.

SOURCE: Archives of Internal Medicine, January 10, 2005.