title: Prognostic value of body mass index and waist circumference in patients with chronic heart failure (Spanish REDINSCOR Registry).
abstract: OBJECTIVE
  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 ≥102cm 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 >120cm.
  
  
  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.
authors.affiliation: Servicio de Epidemiología Clínica, Hospital de la Santa Creu i Sant Pau, IIb-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: TPuig@santpau.cat.
authors.forename: Teresa
authors.initials: T
authors.lastname: Puig
authors.affiliation: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIb-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Andreu
authors.initials: A
authors.lastname: Ferrero-Gregori
authors.affiliation: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIb-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Eulalia
authors.initials: E
authors.lastname: Roig
authors.affiliation: Servicio de Cardiología, Hospital Puerta del Mar, Cádiz, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Vazquez
authors.affiliation: Servicio de Cardiología, Hospital Clínico, Santiago de Compostela, A Coruña, Spain.
authors.forename: Jose R
authors.initials: JR
authors.lastname: Gonzalez-Juanatey
authors.affiliation: Servicio de Cardiología, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: Domingo
authors.initials: D
authors.lastname: Pascual-Figal
authors.affiliation: Servicio de Cardiología, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Delgado
authors.affiliation: Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Alonso-Pulpon
authors.affiliation: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIb-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Borras
authors.affiliation: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIb-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Mendez
authors.affiliation: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, IIb-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Cinca
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D013030:Spain / Q000453:epidemiology; D055105:Waist Circumference
keywords: Body mass index; Estudio multicéntrico; Heart failure; Insuficiencia cardiaca; Multicenter study; Obesity paradox; Paradoja de la obesidad; Perímetro de cintura; Prognosis; Pronóstico; Waist circumference; Índice de masa corporal