Obesity, weight loss and heart failure

Background The current scientific data controversially indicate obesity both as a risk factor for developing congestive heart failure (CHF) and a positive prognostic factor. Aims The present study evaluated the impact of weight loss on clinical and instrumental parameters in a selected group of obese patients with CHF. Methods An overall population of 560 HF patients was sub-grouped on the basis of the Body Mass Index (BMI): 8.2% were underweight (BMI < 20.7), 63.9% normal weight (BMI: 20.7-27.7), 19.6% overweight (BMI: 27.8-31), and 8.3% obese (BMI > 31). Of the 46 overweight and obese patients, 28 (55.2% men, age 51-80 years) accepted a tailored low-caloric dietary program for at least 4 months. The 28 patients belonged to both obese and overweight groups (BMI > 27.8) and were in NYHA classes II-III. Mean follow-up was 5 months. Results The mean toss of body weight was 4 kg in 81.4% of patients, versus 3 kg mean increase in whole (560 patients) population (72.5-75.5 kg). In the 28 patients we recorded a significant (p < 0.05) improvement of NYHA class, better control of arterial blood pressure and statistically significant (p < 0.05) lowering of total cholesterol and triglyceride levels. Conclusions Tailored dietetic program may improve clinical and instrumental parameters in patients with CHF. (C) 2004 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.