Obesity Is an Independent Risk Factor for Heart Failure: Zona Franca Cohort Study
Obesity Is an Independent Risk Factor for Heart Failure: Zona Franca Cohort Study
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DOI：
10.1002/clc.20837
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发表时间：
2010-12-01
影响因子：
2.7
通讯作者：
Schroder, Helmut
中科院分区：
文献类型：
--
作者：
Baena-Diez, Jose M.;Byram, Alice O.;Schroder, Helmut
背景：心力衰竭（HF）是发达国家的一个主要问题。然而，它与肥胖的关系仍不清楚，特别是在低风险人群中。本研究的目的是分析肥胖和HF之间的关系，在低风险的地中海population.Hypothesis：肥胖是一个独立的预测因子HF.Methods：一个前瞻性的社区为基础的人群队列研究与10年的随访进行了2个医疗中心在巴塞罗那市，西班牙。从35275例登记人群中，该研究包括932例随机选择的无HF患者，年龄35-84岁。根据欧洲心脏病学会指南，肥胖定义为体重指数（BMI）≥ 30和HF，并经超声心动图证实。考克斯比例风险回归分析肥胖与心力衰竭之间的关系。结果：肥胖受试者（4.7%）和非肥胖受试者（1.6%）之间的HF发病率差异为3.1%（95%置信区间[CI]：0.7-5.5）。在未校正的模型中，HF事件与BMI显著相关：每增加1 kg/m2，风险比[HR]为1.09（95%CI：1.05-1.14），BMI ≥ 30的风险比[HR]为3.01（95%CI：1.34-6.77）。校正年龄、性别、高血压、缺血性心脏病和糖尿病后，结果相似：HR 1.06（95%CI：1.01-1.10），BMI >= 30的HR 2.45（95%CI：1.02-5.61）。在任何模型中，超重与HF无关。人群归因于肥胖的HF风险为43.0%（95%CI：13.9-74.9）。结论：高比率差异、HR和归因风险表明肥胖是HF事件的重要危险因素。
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/m(2) 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.