Dilruba Ahmed1, Md. Roushon Ali2

Abstract:
Obesity is a worldwide health problem that results in a significant increased risk
of morbidity and Mortality specially cerebrovascular and coronary heart disease.
But it may not always be true. A higher body mass index (BMI) carries a survival
benefit in patients with heart failure. Data from more than 28000 patients with
heart failure support the view that the optimal BMI ranges between 30 and 35
kg/m2 as opposed to the common belief that weight loss and being slim is generally
good. In chronic diseases such as heart failure, chronic kidney disease, or chronic
obstructive pulmonary disease, this assumption no longer holds true, because of
a phenomenon called the “obesity paradox”, and weight loss is no longer advisable.
The origin of this clinical observation is not entirely clear, but some factors may
have an influence: obese patients with heart failure are on average younger, have
better nutritional status and appetite, present at an earlier stage of the disease,
are less catabolic, have lower levels of natriuretic peptides and have higher muscle
mass. An optimal BMI has not been defined, and it is not clear if fat mass is as
beneficial as muscle mass when looking at absolute BMI values.
Keywords: Heart failure, Muscle, Obesity, Obesity paradox.

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