Research
Hormonal
Central adiposity (measured by waist-to-height ratio) is a stronger predictor of HFpEF development and severity than systemic hypertension, and adiposity drives hypertension rather than vice versa.
HFpEF patients should prioritize weight loss and visceral fat reduction over aggressive blood pressure targeting alone, as adiposity is the primary driver of the disease process and arterial stiffness.
GoodSupportsHIGH confidence
Taken together, the totality of evidence suggests that—in the current era—central adiposity appears to be more important than hypertension as a determinant of the evolution and progression of HFpEF.
Why this rating
Supported by Mendelian randomization, observational data, and mechanistic studies.
Source
Central Adiposity or Hypertension
Milton Packer et al. · Journal of the American College of Cardiology · 2025
DOI 10.1016/j.jacc.2025.08.036
narrative_reviewCited 13×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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