Primary Health Care Center La Marina, Primary Care Research Institute Jordi Gol, Barcelona, Spain.
Clin Cardiol. 2010 Dec;33(12):760-4. doi: 10.1002/clc.20837.
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.
Obesity is an independent predictor for HF.
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.
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).
High rate differences, HRs, and attributable risk indicate that obesity is an important risk factor for incident HF.
心力衰竭（HF）是发达国家的一个主要问题。然而，它与肥胖的关系尚不清楚，尤其是在低危人群中。本研究的目的是分析低危地中海人群中肥胖与 HF 之间的关系。
肥胖是 HF 的独立预测因子。
这是一项在西班牙巴塞罗那市的 2 家医疗保健中心进行的前瞻性基于社区的人群队列研究，随访时间为 10 年。从注册的 35275 名人群中，选择了 932 名年龄在 35-84 岁之间、无 HF 的随机患者。肥胖的定义为体重指数（BMI）≥30，根据欧洲心脏病学会指南，通过超声心动图确认 HF。使用 Cox 比例风险回归检验肥胖与 HF 之间的关联。
肥胖患者（4.7%）和非肥胖患者（1.6%）的 HF 发生率差异为 3.1%（95%置信区间[CI]：0.7-5.5）。在未调整模型中，HF 的发生率与 BMI 显著相关：每增加 1kg/m²，风险比[HR]为 1.09（95%CI：1.05-1.14），BMI≥30 时为 3.01（95%CI：1.34-6.77）。调整年龄、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 时 HR 为 2.45（95%CI：1.02-5.61）。超重与任何模型中的 HF 均无关。肥胖导致 HF 的人群归因风险为 43.0%（95%CI：13.9-74.9）。
高率差异、HR 和归因风险表明肥胖是 HF 发病的重要危险因素。
