Body composition and heart failure subtypes in the UK Biobank: a prospective study of 500,000 adults

Abstract Background Obesity has been associated with increased heart failure (HF) risk. However, the shape and strength of associations between different adiposity measures HF subtypes remain unclear. Purpose This study investigated various incidence subtypes. Methods In 2006–2010, 502,599 adults (age 40–70 years) were recruited from UK general population. Resurvey on a subset 20,346 participants was conducted in 2012–13. Participants followed up by linkage to electronic health records. Analyses exclude major cardiac vascular diseases at baseline. Regression dilution ratios (RDR) calculated using Pearson's correlation method obtain usual levels each measure. Association (body mass index [BMI], waist circumference [WC] waist-hip ratio [WHR]) incident determined Cox proportional hazards regression models. Hazard (HRs) are presented as per equivalent 5 BMI units higher Results After exclusions, 428,087 individuals (mean age 55.9 years, 56% women) remained. Over median follow-up 12.8 there 8,669 first-ever events (5205 men 3464 women). Increasing positively log-linearly risk HF. Associations notably stronger for central adiposity, e.g. WC (HR 12.2 1.66, 95% CI 1.62–1.70) compared 1.56, 1.53–1.60). Compared within lowest quintile measure, Individuals highest had an adjusted HR (aHR) 2.65 (95% CI, 2.54–2.75), those aHR 3.21 3.07–3.36) while WHR 3.34 3.16–3.53). Among aetiologic subtypes, hypertensive 2.09, 1.92–2.27; 1.91, 1.78–2.04) mixed aetiology 1.89, 1.82–1.96; 1.61–1.71) showed association ischaemic 1.27, 1.21–1.34; 1.21, 1.16–1.27) valvular 1.08–1.36; 1.18, 1.06–1.31) weaker adiposity. preserved ejection fraction (HFpEF) than reduced (HFrEF) non-fatal fatal Conclusions Adiposity especially HF; strongly HFpEF HFrEF. Funding Acknowledgement Type funding sources: Public Institution(s). Main source(s): Nuffield Department Population Health Doctoral Scholarship