Obesity as a risk factor for heart failure: overview of systematic reviews
DOI:
https://doi.org/10.33448/rsd-v11i1.24380Keywords:
Heart Failure; Obesity; Obesity paradox.Abstract
The overweight and population with obesity has an increased risk of mortality from HF. However, some studies point to the existence of an "obesity paradox" where there could be a protective effect on the relative risk of death by HF in these populations with high BMI. In this way, the present study aimed to investigate obesity as a risk factor for heart failure. For this, an overview of systematic reviews was performed by selecting articles from the following databases: "Pubmed", "Scopus" and "SciElo”. A total of 615 articles were found from this initial search, leaving 59 articles for full-text reading, of which 22 articles were included for data extraction using the predefined inclusion criteria. From these 22 studies 73% were meta-analysis and 64% of the studies are of high methodological quality according to AMSTAR-2. Overweight and obesity have demonstrated a close relationship with the onset and increase of mortality by HF, studies have even been found that point to a gene interference in this relationship. In studies reporting on the obesity paradox, the results pointed to a momentary protection from mortality risk.
References
Aune, D., Sen, A., Norat, T., Janszky, I., Romundstad, P., Tonstad, S., & Vatten, L. J. (2016). Body mass index, abdominal fatness, and heart failure incidence and mortality: A systematic review and dose-response meta-analysis of prospective studies. Circulation, 133(7), 639–649. https://doi.org/10.1161/CIRCULATIONAHA.115.016801
Berger, S., Meyre, P., Blum, S., Aeschbacher, S., Ruegg, M., Briel, M., & Conen, D. (2018). Bariatric surgery among patients with heart failure: A systematic review and meta-analysis. Open Heart, 5(2). https://doi.org/10.1136/openhrt-2018-000910
Bleumink, G. S., Knetsch, A. M., Sturkenboom, M. C. J. M., Straus, S. M. J. M., Hofman, A., Deckers, J. W., Witteman, J. C. M., & Stricker, B. H. C. (2004). Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure: The Rotterdam Study. European Heart Journal, 25(18), 1614–1619.
Chang, H.-W., Li, Y.-H., Hsieh, C.-H., Liu, P.-Y., & Lin, G.-M. (2015). Association of body mass index with all-cause mortality in patients with diabetes: a systemic review and meta-analysis. Cardiovascular Diagnosis and Therapy, 6(2), 109–119. https://doi.org/10.21037/cdt.2015.12.06
Chrysant, S. G., & Chrysant, G. S. (2013). New insights into the true nature of the obesity paradox and the lower cardiovascular risk. Journal of the American Society of Hypertension, 7(1), 85–94. https://doi.org/10.1016/j.jash.2012.11.008
Comitê, C. da D. de I. (2018). Diretriz Brasileira de Insuficiência Cardíaca Crônica e Aguda. Arquivos Brasileiros de Cardiologia, 111(3), 436–539.
Cuspidi, C., Rescaldani, M., Sala, C., & Grassi, G. (2014). Left-ventricular hypertrophy and obesity: A systematic review and meta-analysis of echocardiographic studies. Journal of Hypertension, 32(1), 16–25. https://doi.org/10.1097/HJH.0b013e328364fb58
Fall, T., Hägg, S., Mägi, R., Ploner, A., Fischer, K., Horikoshi, M., Sarin, A.-P., Thorleifsson, G., Ladenvall, C., Kals, M., Kuningas, M., Draisma, H. H. M., Ried, J. S., van Zuydam, N. R., Huikari, V., Mangino, M., Sonestedt, E., Benyamin, B., Nelson, C. P., … Prokopenko, I. (2013). The Role of Adiposity in Cardiometabolic Traits: A Mendelian Randomization Analysis. PLoS Medicine, 10(6). https://doi.org/10.1371/journal.pmed.1001474
Green, S., Higgins, J. P. T., Alderson, P., Clarke, M., Mulrow, C. D., & Oxman, A. D. (2011). Chapter 1: introduction. Cochrane Handbook for Systematic Reviews of Interventions Version, 5(0), 11–102.
Hägg, S., Fall, T., Ploner, A., Mägi, R., Fischer, K., Draisma, H. H. M., Kals, M., De Vries, P. S., Dehghan, A., Willems, S. M., Sarin, A.-P., Kristiansson, K., Nuotio, M.-L., Havulinna, A. S., De Bruijn, R. F. A. G., Ikram, M. A., Kuningas, M., Stricker, B. H., Franco, O. H., … consortium, E. N. for G. and G. E. (ENGAGE). (2015). Adiposity as a cause of cardiovascular disease: A Mendelian randomization study. International Journal of Epidemiology, 44(2), 578–586. https://doi.org/10.1093/ije/dyv094
Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (2019). Cochrane handbook for systematic reviews of interventions. John Wiley & Sons.
Krittanawong, C., Tunhasiriwet, A., Wang, Z., Zhang, H., Prokop, L. J., Chirapongsathorn, S., Sun, T., Kitai, T., & Tang, W. H. W. (2018). Meta-Analysis Comparing Frequency of Overweight Versus Normal Weight in Patients With New-Onset Heart Failure. The American Journal of Cardiology, 121(7), 836–843. https://doi.org/10.1016/j.amjcard.2017.12.021
Lin, G.-M., Li, Y.-H., Yin, W.-H., Wu, Y.-W., Chu, P.-H., Wu, C.-C., Hsu, C.-H., Wen, M.-S., Voon, W.-C., Wang, C.-C., Yeh, S.-J., Lin, W.-S., Chan, K.-C., Chang, H.-C., Chang, K.-C., Chen, Z.-C., Chen, S.-M., Chu, P.-H., Hsu, C.-H., … Yin, W.-H. (2016). The Obesity-Mortality Paradox in Patients With Heart Failure in Taiwan and a Collaborative Meta-Analysis for East Asian Patients. The American Journal of Cardiology, 118(7), 1011–1018. https://doi.org/10.1016/j.amjcard.2016.06.056
Ma, W.-Q., Sun, X.-J., Wang, Y., Han, X.-Q., Zhu, Y., & Liu, N.-F. (2018). Does body mass index truly affect mortality and cardiovascular outcomes in patients after coronary revascularization with percutaneous coronary intervention or coronary artery bypass graft? A systematic review and network meta-analysis. Obesity Reviews, 19(9), 1236–1247. https://doi.org/10.1111/obr.12713
Mahajan, R., Stokes, M., Elliott, A., Munawar, D. A., Khokhar, K. B., Thiyagarajah, A., Hendriks, J., Linz, D., Gallagher, C., Kaye, D., Lau, D., & Sanders, P. (2020). Complex interaction of obesity, intentional weight loss and heart failure: a systematic review and meta-analysis. Heart, 106(1), 58–68. https://doi.org/10.1136/heartjnl-2019-314770
Mancini, M. (2015). Tratado de Obesidade (2nd ed.). Guanabara Koogan.
McDowell, K., Petrie, M. C., Raihan, N. A., & Logue, J. (2018). Effects of intentional weight loss in patients with obesity and heart failure: a systematic review. Obesity Reviews, 19(9), 1189–1204. https://doi.org/10.1111/obr.12707
Milajerdi, A., Djafarian, K., Shab-Bidar, S., & Speakman, J. R. (2019). Pre- and post-diagnosis body mass index and heart failure mortality: a dose-response meta-analysis of observational studies reveals greater risk of being underweight than being overweight. Obesity Reviews, 20(2), 252–261. https://doi.org/10.1111/obr.12777
Mirzababaei, A., Djafarian, K., Mozafari, H., & Shab-Bidar, S. (2019). The long-term prognosis of heart diseases for different metabolic phenotypes: a systematic review and meta-analysis of prospective cohort studies. Endocrine, 63(3), 439–462. https://doi.org/10.1007/s12020-019-01840-0
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Group, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine, 6(7), e1000097.
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., Das, S. R., De Ferranti, S., Després, J.-P., & Fullerton, H. J. (2016). Executive summary: heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation, 133(4), 447–454.
Oga, E. A., & Eseyin, O. R. (2016). The Obesity Paradox and Heart Failure: A Systematic Review of a Decade of Evidence. Journal of Obesity, 2016, 1–9. https://doi.org/10.1155/2016/9040248
Oreopoulos, A., Padwal, R., Kalantar-Zadeh, K., Fonarow, G. C., Norris, C. M., & McAlister, F. A. (2008). Body mass index and mortality in heart failure: A meta-analysis. American Heart Journal, 156(1), 13–22. https://doi.org/10.1016/j.ahj.2008.02.014
Padwal, R., McAlister, F. A., McMurray, J. J. V, Cowie, M. R., Rich, M., Pocock, S., Swedberg, K., Maggioni, A., Gamble, G., Ariti, C., Earle, N., Whalley, G., Poppe, K. K., Doughty, R. N., & Bayes-Genis, A. (2014). The obesity paradox in heart failure patients with preserved versus reduced ejection fraction: a meta-analysis of individual patient data. International Journal of Obesity, 38(8), 1110–1114. https://doi.org/10.1038/ijo.2013.203
Qin, W., Liu, F., & Wan, C. (2017). A U-shaped association of body mass index and all-cause mortality in heart failure patients: A dose-response meta-analysis of prospective cohort studies. Cardiovascular Therapeutics, 35(2), e12232. https://doi.org/10.1111/1755-5922.12232
Reddy, Y. N. V, Anantha-Narayanan, M., Obokata, M., Koepp, K. E., Erwin, P., Carter, R. E., & Borlaug, B. A. (2019). Hemodynamic Effects of Weight Loss in Obesity: A Systematic Review and Meta-Analysis. JACC: Heart Failure, 7(8), 678–687. https://doi.org/10.1016/j.jchf.2019.04.019
Sharma, A., Lavie, C. J., Borer, J. S., Vallakati, A., Goel, S., Lopez-Jimenez, F., Arbab-Zadeh, A., Mukherjee, D., & Lazar, J. M. (2015). Meta-Analysis of the Relation of Body Mass Index to All-Cause and Cardiovascular Mortality and Hospitalization in Patients With Chronic Heart Failure. The American Journal of Cardiology, 115(10), 1428–1434. https://doi.org/10.1016/j.amjcard.2015.02.024
Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Moher, D., Tugwell, P., Welch, V., & Kristjansson, E. (2017). AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. Bmj, 358.
Shirley, S., Davis, L. L., & Carlson, B. W. (2008). The relationship between body mass index/body composition and survival in patients with heart failure. Journal of the American Academy of Nurse Practitioners, 20(6), 326–332. https://doi.org/10.1111/j.1745-7599.2008.00328.x
Silva, V., Grande, A. J., Martimbianco, A. L. C., Riera, R., & Carvalho, A. P. V. (2012). Overview of systematic reviews - A new type of study. Part I: Why and for whom? Sao Paulo Medical Journal, 130(6), 398–404. https://doi.org/10.1590/S1516-31802012000600007
Sommer, A., & Twig, G. (2018). The Impact of Childhood and Adolescent Obesity on Cardiovascular Risk in Adulthood: a Systematic Review. Current Diabetes Reports, 18(10). https://doi.org/10.1007/s11892-018-1062-9
Thomson, D., Russell, K., Becker, L., Klassen, T., & Hartling, L. (2010). The evolution of a new publication type: Steps and challenges of producing overviews of reviews. Research Synthesis Methods, 1(3‐4), 198–211.
Wawrzeńczyk, A., Anaszewicz, M., Wawrzeńczyk, A., & Budzyński, J. (2019). Clinical significance of nutritional status in patients with chronic heart failure—a systematic review. Heart Failure Reviews, 24(5), 671–700. https://doi.org/10.1007/s10741-019-09793-2
Zhang, J., Begley, A., Jackson, R., Harrison, M., Pellicori, P., Clark, A. L., & Cleland, J. G. F. (2019). Body mass index and all-cause mortality in heart failure patients with normal and reduced ventricular ejection fraction: a dose–response meta-analysis. Clinical Research in Cardiology, 108(2), 119–132. https://doi.org/10.1007/s00392-018-1302-7
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