Research
Hormonal
SGLT2 inhibitors provide consistent cardiovascular benefits (reduced mortality and morbidity) across all BMI classes in heart failure, with no mediating effect of obesity on their efficacy.
If you have heart failure, SGLT2 inhibitors (like Dapagliflozin or Empagliflozin) are a standard, highly effective treatment that works regardless of your weight. They reduce the risk of hospitalization and death. Discuss starting these with your doctor if you are not already on them.
StrongSupportsHIGH confidence
in terms of the efficacy of SGLT2 inhibitors in preventing morbidity and mortality in established HF, there appears to be no mediator effect of obesity in either HFrEF or HFpEF. Reassuringly, the significant benefit is consistent across BMI classes.
Why this rating
Based on multiple RCTs (DAPA-HF, EMPEROR-Reduced, EMPEROR-Preserved, etc.) showing consistent benefit.
Source
Obesity and heart failure: exploring the cardiometabolic axis
Jennifer J. Rayner et al. · Cardiovascular Research · 2025
DOI 10.1093/cvr/cvaf090
narrative_reviewCited 7×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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