The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity Paradox

Authors

DOI:

https://doi.org/10.35898/ghmj-811151

Keywords:

Heart failure, HFrEF, Obesity, Obesity paradox, Quality of life

Abstract

Background: Obesity place patients at risk of cardiovascular disease (CVD). There may be an inverse relationship between obesity and CVD prognosis-a phenomenon known as the “obesity paradox”. Obese HF patients might have a better prognosis, especially in terms of quality of life (QoL).

Aims: The purpose of this study was to examine the QoL of HF patients based on obesity classification.

Methods: This cross-sectional study was conducted at the HF clinic of Hasna Medika Cardiovascular Hospital, Cirebon, Indonesia. Samples were HFrEF patients who had received medication at the HF clinic for at least 6 months and the patient must have received optimal guidelines directed medical therapy (GDMT) with at least 3 pillar drugs according to Indonesian heart failure guidelines. Inclusion criteria were HF patients with ejection fraction <40% on echocardiographic examination. Exclusion criteria were HF patients with motor impairments, such as post-stroke, severe osteoarthritis, paralysis, and patients who did not receive optimal GDMT.

Results: A total of 40.3% sample were obese, 9.7% were underweight and 67.5% had central obesity. Coronary artery disease (89.6%), smoking (67.5%) and hypertension (49.4%) were the most common comorbidities and risk factors found. About 12.3% of sample experienced rehospitalization 3 times a year. Based on Kansas City Cardiomyopathy Questionnaire (KCCQ)-12, about 3.2% of the sample had poor QoL, 55.8% had good QoL and 9.7% had excellent QoL. HFrEF patients with excellent QoL had a proportion of 66.7% obese and 20% overweight. While there were no obese patients in HFrEF patients with poor QoL. The proportion of HFrEF patients with excellent QoL who had central obesity was 80%. Meanwhile, 65.1% of HFrEF patients with good QoL were obese.

Conclusion: Obese HF patients have better QoL outcomes. This phenomenon is called obesity paradox. A good quality of life in HF patients is an important goal of HF management in addition to reducing mortality.

 

Received: 02 December 2024 | Reviewed: 17 December 2024 |

Revised: 24 December 2024 | Accepted: 10 January 2025.

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Author Biographies

  • dr. Yogi Puji Rachmawan, SpJP., Department of Cardiovascular Medicine, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia.

    Yogi Puji Rachmawan currently works as cardiologist at Hasna Medika Cardiovascular Hospital Cirebon and lecturer at Faculty of Medicine, Universitas Swadaya Gunung Jati Cirebon, Indonesia. He received his speciality degree from Diponegoro University, Semarang. He has conducted several researches in cardiovascular medicine with a focus on heart failure and cardiometabolic diseases.

  • dr. Witri Pratiwi, M.Kes, Department of Community Medicine and Public Health, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia

    Witri Pratiwi is a researcher and lecturer at Department of Community Medicine and Public Health, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia. She earned her master's degree in public health from Diponegoro University, Semarang. She has conducted several studies in epidemiology and public health field.

  • Dr. dr. Helda, M.Kes, Department of Epidemiology, Faculty of Public Health, University of Indonesia, Depok, Indonesia.

    Helda is an active researcher in the field of epidemiology. She earned her doctorate in epidemiology from the University of Indonesia. She currently works as a lecturer at the Faculty of Public Health, University of Indonesia.

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Published

2025-01-10

How to Cite

Rachmawan, Y. P., Pratiwi, W., & Helda, H. (2025). The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity Paradox. GHMJ (Global Health Management Journal), 8(1), 23–30. https://doi.org/10.35898/ghmj-811151

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