Mixed
In patients with heart failure and reduced ejection fraction (HFrEF), a BMI greater than 27 kg/m² is associated with significantly higher risks of cardiovascular mortality, heart failure hospitalization, and composite adverse outcomes compared to a BMI of 24–27 kg/m².
If you have heart failure with reduced ejection fraction, maintaining a BMI between 24 and 27 kg/m² is associated with better survival and fewer hospitalizations than having a BMI over 27. This is especially true if your heart failure is caused by coronary artery disease (ischemic). You should discuss weight management strategies with your cardiologist, as higher BMI may increase your risk of cardiovascular death and hospitalization.
A BMI of 35 vs. 27 was associated with non-significant increased all-cause mortality (HR 1.18, 95% CI 0.94–1.48) but significantly higher cardiovascular mortality (HR 1.42, 95% CI 1.05–1.92), HF hospitalization (HR 1.33, 95% CI 1.05–1.67), and composite outcome (HR 1.30, 95% CI 1.06–1.60).
Why this rating
Large cohort (n=1,017), long follow-up (median 8.8 years), and rigorous registry linkage, but it is a post-hoc observational analysis.
Source
Associations of Body Mass Index on worsening of heart failure and mortality in patients with heart failure and reduced left ventricular ejection fraction: A 10-year follow-up study (A NorthStar Substudy)
Morten Malmborg et al. · medRxiv · 2025
DOI 10.1101/2025.05.05.25327040
Related findings · Mixed
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