Prognostic Value of Body Mass Index and Waist Circumference in Patients With Chronic Heart Failure (Spanish REDINSCOR Registry)

Introduction and objectives: To analyze the association between higher body mass index and waist circumference, and the prognostic values of both indicators in total and cardiac mortality in patients with chronic heart failure. Methods: The study included 2254 patients who were followed up for 4 years. Obesity was classified as a body mass index >= 30 and overweight as a body mass index of 25.0-29.9. Central obesity was defined as waist circumference >= 88 cm for women and >= 102 cm for men. Independent predictors of total and cardiac mortality were assessed in a multivariate Cox model adjusted for confounding variables. Results: Obesity was present in 35% of patients, overweight in 43%, and central obesity in 60%. Body mass index and waist circumference were independent predictors of lower total mortality: hazard ratio = 0.84 (P<.001) and hazard ratio = 0.97 (P=.01), respectively, and lower cardiac death (body mass index, hazard ratio = 0.84, P<.001; waist circumference, hazard ratio = 0.97, P=.01). The interaction between body mass index and waist circumference (hazard ratio = 1.001, P<.01) showed that the protective effect of body mass index was lost in patients with a waist circumference > 120 cm. Conclusions: Mortality was significantly lower in patients with a high body mass index and waist circumference. The results also showed that this protection was lost when these indicators over a certain limit. (C) 2013 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L. All rights reserved.