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Abstract

Background:

Heart failure (HF) is a major problem in developed countries. However, its relationship with obesity remains unclear, especially in low-risk populations. The objective of the study was to analyze the relationship between obesity and HF in a low-risk Mediterranean population.

Hypothesis:

Obesity is an independent predictor for HF.

Methods:

A prospective community-based population cohort study with 10 years' follow-up was conducted at 2 healthcare centers in the city of Barcelona, Spain. From a registered population of 35 275, the study included 932 randomly selected patients without HF, age 35–84 years. Obesity was defined as body mass index (BMI) ≥30 and HF according to European Society of Cardiology guidelines, confirmed by echocardiography. Cox proportional hazards regression was used to examine the association between obesity and heart failure.

Results:

The difference in HF incidence between obese subjects (4.7%) and nonobese subjects (1.6%) was 3.1% (95% confidence interval [CI]: 0.7–5.5). In the unadjusted model, incident HF was significantly associated with BMI: the hazard ratio [HR] was 1.09 for every 1 kg/m2 increase (95% CI: 1.05–1.14) and 3.01 for BMI ≥30 (95% CI: 1.34–6.77). After adjusting for age, sex, hypertension, ischemic heart disease, and diabetes mellitus, the results were similar: HR 1.06 (95% CI: 1.01–1.10) and HR 2.45 for BMI ≥30 (95% CI: 1.02–5.61). Overweight was not associated with HF in any of the models. The population-attributable risk of HF due to obesity was 43.0% (95% CI: 13.9–74.9).

Conclusions:

High rate differences, HRs, and attributable risk indicate that obesity is an important risk factor for incident HF. Copyright © 2010 Wiley Periodicals, Inc.

This work was supported by grants from Instituto de Salud Carlos III-FEDER0 (PI080439), and by a joint contract of the Instituto de Salud Carlos III and the Health Department of the Catalan Government.