Mixed
Obesity is a primary driver of Heart Failure with Preserved Ejection Fraction (HFpEF) through cardiometabolic mechanisms including systemic inflammation, lipotoxicity, and metabolic remodeling, rather than being merely a comorbidity.
If you have HFpEF and obesity, your body's metabolism and inflammation are likely driving your heart condition. This is not just about 'being overweight' but involves complex biological changes like fat toxicity and inflammation. Managing obesity through weight loss interventions (like GLP-1 agonists or lifestyle changes) can target these root causes and improve heart health.
In the most common phenotype, known as cardiometabolic HFpEF, obesity is a major driver of cardiac dysfunction. Excessive adiposity promotes several derangements, but the effects of obesity and metabolic syndrome on cardiac metabolism are pivotal in HFpEF progression.
Why this rating
Based on a comprehensive scientific statement from the Heart Failure Association of the ESC, synthesizing epidemiology, translational aspects, and clinical trials.
Source
Heart Failure and Obesity: Translational Approaches and Therapeutic Perspectives. A Scientific Statement of the Heart Failure Association of the ESC
Gianluigi Savarese et al. · European Journal of Heart Failure · 2025
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