Heart failure & cardiomyopathiesResearch article
Body Mass Index, Clinical Outcomes, and Mortality in Heart Failure
- Two-sample Mendelian randomisation study
- Genome-wide association study (GWAS) of time-to-event outcomes
- 22 cohorts
Authors' conclusion
Among patients with HF, higher BMI was associated with increased all-cause mortality and cardiovascular death or HF hospitalization
Study context
- Population
- Individuals of European ancestry with established heart failure (HF) (12 HF trials, 1 case-cohort study, 9 cohorts nested in non-HF CV trials, UK Biobank)
- Participants
- 50,636 individuals · 22 cohorts
- Comparison
- Genetically predicted higher body mass index (BMI)
- Outcome
- All-cause mortality; composite of CV mortality or HF hospitalisation
- Follow-up
- Median 27.0 months
Main finding
As reported in the abstract
Genetically predicted BMI (per SD [4.8 BMI units])
Genetically predicted BMI per SD [4.8 BMI units]Hazard ratio (95% CI)P value
all-cause mortality
1.21(1.13–1.29)
P = 9 × 10-8CV mortality or HF hospitalisation
1.29(1.20–1.38)
P = 8 × 10-13Per SD [4.8 BMI units], as printed
- Mean BMI
- 29.2 ± 5.8 kg/m²
- All-cause mortality events
- 11,454 (23%)
- Composite endpoint events
- 11,360 (22%)
Further findings
By left ventricular ejection fraction (LVEF) subgroup (≤40% and >40%)
| Comparison | HR (95% CI) | |
|---|---|---|
| Genetically predicted BMI · all-cause mortality, LVEF ≤40% | 1.16 (0.99–1.37) | |
| Genetically predicted BMI · all-cause mortality, LVEF >40% | 1.20 (0.94–1.53) | |
| Genetically predicted BMI · composite, LVEF ≤40% | 1.30 (1.15–1.48) | |
| Genetically predicted BMI · composite, LVEF >40% | 1.57 (1.29–1.91) | |
| 0.512Hazard ratio (log scale) |
By LVEF subgroup (≤40% and >40%)
- Associations consistent across LVEF ≤40% and >40%
Original publication
Body Mass Index, Clinical Outcomes, and Mortality in Heart Failure. J Am Coll Cardiol. Published 22 April 2026. doi:10.1016/j.jacc.2026.02.5093
Summarised from the published abstract; every number is checked against it