Heart failure & cardiomyopathiesMeta-analysis
Obesity and Risk of Kidney Outcomes in Heart Failure With Preserved Ejection Fraction
- Participant-level pooled analysis of 4 heart failure with preserved ejection fraction (HFpEF) randomised trials
- multivariable Cox models stratified by trial and treatment
Authors' conclusion
WC and WHtR were associated with an increased risk of kidney outcomes, while BMI was not.
Study context
- Population
- Patients with HFpEF in DELIVER, PARAGON-HF, TOPCAT Americas and I-PRESERVE
- Participants
- 16,919 patients · 4 trials
- Comparison
- Adiposity-related anthropometrics and kidney outcomes
- Outcome
- Kidney outcomes:
- Sustained eGFR reduction ≥50%
- End-stage kidney disease
- Kidney-related death
Pooled result
As reported in the abstract
Kidney outcomes · median 2.3 years
Hazard ratio (95% CI)P value
BMI per 1 kg/m²
0.99(0.96–1.02)
P = 0.45WC per 10 cm
1.15(1.01–1.31)
P = 0.03WHtR per 0.1 unit
1.32(1.07–1.62)
P = 0.01Each row per its own increment, as printed
- Kidney outcome events
- 339
Further pooled results
Prevalence of adiposity
- Normal/underweight by body mass index (BMI)
- 18%
- Overweight by BMI
- 35%
- Obesity by BMI
- 47%
- Elevated waist-to-height ratio (WHtR) (≥0.5)
- 95%
- Waist circumference (WC), n = 6,177 (Q1-Q3: 95-116 cm)
- 105 cm
Original publication
Obesity and Risk of Kidney Outcomes in Heart Failure With Preserved Ejection Fraction. JACC Heart Fail. Published 9 June 2025. doi:10.1016/j.jchf.2025.03.042
Summarised from the published abstract; every number is checked against it