The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity Paradox
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...
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Yayasan Aliansi Cendekiawan Indonesia Thailand
2025-01-01
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| Series: | GHMJ (Global Health Management Journal) |
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| Online Access: | https://publications.inschool.id/index.php/ghmj/article/view/1151 |
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| author | Yogi Puji Rachmawan Witri Pratiwi Helda Helda |
| author_facet | Yogi Puji Rachmawan Witri Pratiwi Helda Helda |
| author_sort | Yogi Puji Rachmawan |
| collection | DOAJ |
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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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| format | Article |
| id | doaj-art-9e4cc762aecd429ca01efcc400905c31 |
| institution | Kabale University |
| issn | 2580-9296 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Yayasan Aliansi Cendekiawan Indonesia Thailand |
| record_format | Article |
| series | GHMJ (Global Health Management Journal) |
| spelling | doaj-art-9e4cc762aecd429ca01efcc400905c312025-01-13T10:16:33ZengYayasan Aliansi Cendekiawan Indonesia ThailandGHMJ (Global Health Management Journal)2580-92962025-01-018110.35898/ghmj-811151The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity ParadoxYogi Puji Rachmawan0https://orcid.org/0000-0002-7976-5772Witri Pratiwi1https://orcid.org/0000-0001-8714-9198Helda Helda2https://orcid.org/0000-0001-5212-8864Department of Cardiovascular Medicine, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Indonesia.Department of Community Medicine and Public Health, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, IndonesiaDepartment of Epidemiology, Faculty of Public Health, University of Indonesia, Depok, Indonesia. 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. https://publications.inschool.id/index.php/ghmj/article/view/1151Heart failureHFrEFObesityObesity paradoxQuality of life |
| spellingShingle | Yogi Puji Rachmawan Witri Pratiwi Helda Helda The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity Paradox GHMJ (Global Health Management Journal) Heart failure HFrEF Obesity Obesity paradox Quality of life |
| title | The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity Paradox |
| title_full | The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity Paradox |
| title_fullStr | The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity Paradox |
| title_full_unstemmed | The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity Paradox |
| title_short | The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity Paradox |
| title_sort | quality of life in heart failure reduced ejection fraction hfref patients a phenomenon of obesity paradox |
| topic | Heart failure HFrEF Obesity Obesity paradox Quality of life |
| url | https://publications.inschool.id/index.php/ghmj/article/view/1151 |
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