Having extra pounds linked to heart risks


Published: Thursday, August 1, 2002 at 6:01 a.m.
Last Modified: Thursday, August 1, 2002 at 12:00 a.m.
Researchers have found another reason to watch your waistline: Being even modestly overweight increases the chances of developing heart failure.
Extreme obesity has already been linked to heart failure, but whether that was true for milder weight problems wasn't as firmly established.
A study of 5,881 men and women published in today's New England Journal of Medicine showed that the risk of heart failure is double in obese people and 34 percent higher in those overweight, compared with those of normal weight.
Researchers also determined that the risk rose gradually with weight levels.
Between 2 million and 3 million Americans have heart failure, which occurs when the heart isn't able to pump enough blood through the body. Symptoms include shortness of breath, fatigue and swollen feet and ankles.
Some of the risk factors for heart failure - diabetes, high blood pressure and heart disease - also are linked to excess pounds. The researchers looked at whether the extra weight influences the risk of heart failure.
They reviewed data from the long-running, government-funded Framingham Heart Study and compared weight and the rate of heart failure in the study participants. They were followed for 14 years, and heart failure was diagnosed in 496 of them.
The researchers calculated there was an increase in the risk of heart failure of 5 percent for men and 7 percent for women for each increment of 1 in the body mass index. A normal weight is a BMI of less than 25; overweight is under 30 and obesity is over 30. BMI is determined by dividing weight in pounds by height in inches, dividing again by height in inches and multiplying by 703.
About 11 percent of the cases of heart failure in men and 14 percent among women were due to obesity alone.
"Clearly what we know is that obesity increases heart failure. The mechanism - how obesity causes that - we need further investigation," Vasan said.
He noted that research has linked obesity to enlargement and thickening of the left ventricle, the heart's main pumping chamber, which can progress to heart failure.
Based on the new study and others, "overweight and, particularly, obesity should now be added to the list of risk factors for the development of heart failure," Dr. Barry M. Massie of the University of California, San Francisco, wrote in an accompanying editorial.
He said doctors may want to consider medications that also help prevent heart failure while treating overweight and obese patients for such things as diabetes, high blood pressure and heart disease. Overweight and obese patients should be included more frequently in research to determine what works best for them, he said.

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