Cardiometabolic Disease Leading to Heart Failure: Better Fat and Fit Than Lean and Lazy

Abstract

High body mass index (BMI) and low cardiorespiratory fitness (CRF) are important modifiable risk factors for heart failure (HF). While the individual contributions of CRF and BMI toward risk for HF are well established, the interrelationship between BMI and CRF in modifying long-term HF risk is more complex and not well understood. In this review, we discuss and summarize the available evidence-base on individual and joint contributions of obesity and low CRF toward HF risk, including the potential mechanisms through which these lifestyle risk factors may lead to HF. We also discuss the role of interventions aimed at intentional loss of weight or CRF improvement as potential HF preventive strategies. Finally, the article also highlights the modifying effects of CRF on survival in relation to the obesity paradox in patients with established HF.

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Abbreviations

BMI:

Body mass index

CCLS:

Cooper Center for Longitudinal Study

CHD:

Coronary heart disease

CRF:

Cardiorespiratory fitness

CV:

Cardiovascular

CVD:

Cardiovascular disease

DM:

Diabetes mellitus

HF:

Heart failure

HTN:

Hypertension

LV:

Left ventricle or ventricular

LVH:

Left ventricular hypertrophy

MET:

Metabolic equivalent

MetS:

Metabolic syndrome

PA:

Physical activity

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Conflict of Interest

Ambarish Pandey: None

Jarett D. Berry: None

Carl J. Lavie has received personal fees outside of the submitted work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Carl J. Lavie.

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This article is part of the Topical Collection on Epidemiology of Heart Failure

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Pandey, A., Berry, J.D. & Lavie, C.J. Cardiometabolic Disease Leading to Heart Failure: Better Fat and Fit Than Lean and Lazy. Curr Heart Fail Rep 12, 302–308 (2015). https://doi.org/10.1007/s11897-015-0265-5

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Keywords

  • Obesity
  • Heart failure
  • Cardiorespiratory fitness
  • Physical activity
  • Exercise