Abstract 13157: Relationship Between Body Mass Index and Mortality in the African-American Heart Failure Trial
Introduction: In patients with heart failure and reduced ejection fraction (HFrEF), increasing body mass index (BMI) is not associated with worsening prognosis, termed the obesity paradox. Although this phenomenon has been studied extensively, data on the African-American population are limited. The aim of this study was to examine the relationship between BMI and all-cause mortality in African Americans with HFrEF.
Methods and Results: The African-American Heart Failure Trial (A-HeFT) database was utilized to conduct a retrospective analysis. In A-HeFT, 1050 self-identified black patients with BMI range of 15.7 to 69.4 kg/m2 (median 30.3 kg/m2) were followed for a median of 15 months, with 86 deaths. BMI was modeled as a curvilinear continuous variable using restricted cubic splines. Unadjusted Cox regression analysis of the relationship between BMI and all-cause mortality revealed a significant (p = 0.001) inverse relationship, with an increase in mortality risk below the median BMI of approximately 30 kg/m2 (HR> 1.0) without an upward trend in mortality risk above a BMI > 30 kg/m2 (Figure1). Adjustment for other variables including age, sex, comorbidities, and clinical assessments did not reveal an increase in HR above the median BMI.
Conclusion: Consistent with the obesity paradox, the mortality risk increased with decreasing BMI and did not increase when the BMI exceeded the definition of obesity. Until the mechanisms of the obesity paradox are better understood, these results question whether weight reduction would be beneficial in the African American population with HFrEF.
Author Disclosures: O. Oluleye: None. K. Baxi: None. T. Rector: None. P. Ngo: None. A. Miller: None. I.S. Anand: None.
- © 2016 by American Heart Association, Inc.