Heart failure treatment in patients with and without obesity with an ejection fraction below 50%

Yaar S. Aga, Sumant P. Radhoe, Dilan Aydin, G. C.M. Linssen, Philip C. Rademaker, Peter R. Geerlings, Marco W.F. van Gent, Ismail Aksoy, Liane Oosterom, Hans Peter Brunner-La Rocca, Bas M. van Dalen, Jasper J. Brugts*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

17 Downloads (Pure)


Background: The aim of this study was to assess heart failure (HF) treatment in patients with and without obesity in a large contemporary real-world Western European cohort. Methods: Patients with a left ventricular ejection fraction (LVEF) <50% and available information on body mass index (BMI) were selected from the CHECK-HF registry. The CHECK-HF registry included chronic HF patients in the period between 2013 and 2016 in 34 Dutch outpatient clinics. Patients were divided into BMI categories. Differences in HF medical treatment were analysed, and multivariable logistic regression analysis (dichotomized as BMI <30 kg/m2 and ≥30 kg/m2) was performed. Results: Seven thousand six hundred seventy-one patients were included, 1284 (16.7%) had a BMI ≥30 kg/m2, and 618 (8.1%) had a BMI ≥35 kg/m2. Median BMI was 26.4 kg/m2. Patients with obesity were younger and had a higher rate of comorbidities such as diabetes mellitus, hypertension and obstructive sleep apnoea (OSAS). Prescription rates of guideline-directed medical therapy (GDMT) increased significantly with BMI. The differences were most pronounced for mineralocorticoid receptor antagonists (MRAs) and diuretics. Patients with obesity more often received the guideline-recommended target dose. In multivariable logistic regression, obesity was significantly associated with a higher likelihood of receiving ≥100% of the guideline-recommended target dose of beta-blockers (OR 1.34, 95% CI 1.10–1.62), renin–angiotensin system (RAS)-inhibitors (OR 1.34, 95% CI 1.15–1.57) and MRAs (OR 1.40, 95% CI 1.04–1.87). Conclusions: Guideline-recommended HF drugs are more frequently prescribed and at a higher dose in patients with obesity as compared to HF patients without obesity.

Original languageEnglish
Article numbere13976
JournalEuropean Journal of Clinical Investigation
Issue number7
Publication statusPublished - Jul 2023

Bibliographical note

Funding Information:
The steering committee (H.-P.B.-L.R., G.C.M.L. and J.J.B.) received no funding for this project. This analysis was initiated by the authors and was designed, conducted, interpreted and reported independently of the sponsor, Servier, who funded in part the database and software program.

Publisher Copyright:
© 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.


Dive into the research topics of 'Heart failure treatment in patients with and without obesity with an ejection fraction below 50%'. Together they form a unique fingerprint.

Cite this