Evidence mapPaperPMID 40932106Full record

ArticleJournal of the American Heart Association2025

Association of Long-Term Body Mass Index Variability With the Development of Heart Failure With Preserved Ejection Fraction and Heart Failure With Reduced Ejection Fraction Across Patterns of Weight Change.

Zeshui Yu, Yuqing Chen, Oshin Miranda, Meiyuzhen Qi, Manling Zhang, Ning Feng, Timothy P Ryan, Nanette Cathrin Schloot, Yu Chen, Flora Sam and 1 more

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Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Zeshui YuDepartment of Pharmaceutical Sciences University of Pittsburgh, School of Pharmacy Pittsburgh PA USA.ORCID 0009-0002-4535-8770
Yuqing ChenDepartment of Epidemiology Graduate School of Public Health, University of Pittsburgh Pittsburgh PA USA.ORCID 0000-0001-5167-1080
Oshin MirandaDepartment of Pharmaceutical Sciences University of Pittsburgh, School of Pharmacy Pittsburgh PA USA.
Meiyuzhen QiDepartment of Epidemiology Graduate School of Public Health, University of Pittsburgh Pittsburgh PA USA.ORCID 0000-0003-0180-3588
Manling ZhangDivision of Cardiology Vascular Medicine Institute, University of Pittsburgh School of Medicine Pittsburgh PA USA.ORCID 0000-0003-2689-1465
Ning FengDivision of Cardiology Vascular Medicine Institute, University of Pittsburgh School of Medicine Pittsburgh PA USA.ORCID 0000-0003-3639-3128
Timothy P RyanLilly Research Laboratories Eli Lilly and Company, Lilly Corporate Center Indianapolis IN USA.
Nanette Cathrin SchlootLilly Deutschland GmbH Bad Homburg Germany.ORCID 0000-0003-3737-4316
Yu ChenLilly Research Laboratories Eli Lilly and Company, Lilly Corporate Center Indianapolis IN USA.ORCID 0009-0008-5331-0463
Flora SamLilly Research Laboratories Eli Lilly and Company, Lilly Corporate Center Indianapolis IN USA.ORCID 0000-0001-8442-9362
Lirong WangDepartment of Pharmaceutical Sciences University of Pittsburgh, School of Pharmacy Pittsburgh PA USA.ORCID 0000-0003-1797-9967

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBody mass index (BMI) variability is a risk factor for various adverse cardiovascular outcomes. However, the specific associations between BMI variability and the risk of developing heart failure with preserved ejection fraction (HFpEF) versus heart failure with reduced ejection fraction (HFrEF), particularly across multiple weight change trends, remain unexplored.

methodsThis retrospective cohort study analyzed electronic health records from a sample of patients with overweight or obesity. BMI variability was assessed over a 5-year period using average successive variability, with patients categorized into 3 groups: weight loss, stable weight, and weight gain. We subsequently followed 50 812 eligible patients to monitor the incidence of HFpEF and HFrEF. Cox regression models were applied to examine the differential association between BMI variability and HFpEF and HFrEF risk.

resultsOver a median follow-up of 4.52 years, 2128 patients developed HFpEF and 1121 developed HFrEF. After adjusting for relevant confounders, elevated BMI variability was associated with an increased risk of HFpEF. The hazard ratios (HRs) of HFpEF for each 1-SD increment in average successive variability of BMI were 1.37 (95% CI, 1.17-1.59) in the weight loss group and 1.24 (95% CI, 1.11-1.40) in the stable weight group. Additionally, when analyzed as a binary variable divided by the median, BMI variability above the median was associated with higher risks of HFpEF compared with those below the median, with the corresponding HRs being 1.47 (95% CI, 1.21-1.79) for the weight loss group and 1.20 (95% CI, 1.06-1.35) for the stable weight group. Among patients who experienced weight gain, BMI variability was not significantly associated with the risk of incident HFpEF or HFrEF (HR, 1.16 [95% CI, 0.88-1.53]; modeled as a continuous variable).

conclusionsIn this large cohort of individuals living with overweight or obesity, greater variability in BMI was significantly associated with a higher risk of developing HFpEF among those with reduced or stable weight.

Indexed as

Body Mass IndexHeart FailureObesityStroke VolumeVentricular Function, LeftWeight GainWeight LossAgedFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsBMI variabilityHFpEFHFrEFlongitudinal studyweight change pattern

Identifiers

PMID40932106
PMCPMC12554408

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