title: Fluctuations of the anthropometric indices and mortality of patients with incident heart failure: a prospective study in the community.
abstract: BACKGROUND
  The relationship between the fluctuations of the anthropometric indices (AIs) and the prognosis of patients with incident heart failure (HF) in a population-based cohort is unknown.
  
  
  OBJECTIVE
  To assess the relationship between the fluctuations of the AIs, body mass index (BMI), waist hip ratio (WHR), and weight height ratio (WHeR) and the prognosis of patients with incident HF.
  
  
  METHODS
  Anthropometric indices were prospectively measured in a 10-year population-based study of 6492 patients with incident HF (GAMIC cohort). 4530 patients (66.7%) died, during a mean follow-up of 72.7 ± 14.2 months. A time-updated analysis of the changes of the AIs was performed to assess their association with mortality and morbidity (hospitalisations and visits).
  
  
  RESULTS
  Patients with incident HF presenting ≥ 5% decrease or ≥ 7% increase of the AIs have an increased mortality [HR ≥ 1.65 (1.52-2.34) or HR ≥ 1.71 (1.58-1.85), respectively, p < 0.001]. Mortality risk increased ≥ 1.43-fold (p = -0.0003) for each 10% change in the AIs. There was an accelerated pattern of reduction in the AIs in the 6 months prior to death, and an accelerated increase in the AIs in the 3 months prior to hospitalisation. These observations were independent of the aetiology (ischaemic vs. non-ischaemic), the type of HF (systolic vs. non-systolic), and other predictors of mortality.
  
  
  CONCLUSIONS
  Time-updated changes (increase or decrease) of the AIs, BMI, WHR and weight height ratio are independently associated with the mortality of patients with incident HF.
authors.affiliation: Department of Medicine, Hospital Universitario Puerto Real, School of Medicine, University of Cadiz, Cadiz, Spain.
authors.forename: R M
authors.initials: RM
authors.lastname: Aranda
authors.forename: J L
authors.initials: JL
authors.lastname: Puerto
authors.forename: J L
authors.initials: JL
authors.lastname: Andrey
authors.forename: M A
authors.initials: MA
authors.lastname: Escobar
authors.forename: A
authors.initials: A
authors.lastname: García-Egido
authors.forename: S P
authors.initials: SP
authors.lastname: Romero
authors.forename: M J
authors.initials: MJ
authors.lastname: Pedrosa
authors.forename: F
authors.initials: F
authors.lastname: Gómez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000453:epidemiology / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D049629:Waist-Hip Ratio / Q000706:statistics & numerical data