USA: In a groundbreaking study that may have profound implications for cardiovascular health, researchers have uncovered a significant association between high variability of body mass index (BMI) and heart failure (HF) incidence. This finding, published in the Journal of the American Heart Association, underscores the importance of maintaining stable body weight in mitigating the risk of developing this life-threatening condition.

The UK Biobank study analyzing data from over 99,000 participants revealed that higher variability in BMI is independently linked to a heightened heart failure risk.
"Over a median follow-up of 12.5 years, subjects with higher BMI variability showed an increased risk of HF incidence (HR: 1.05 - 1.07), independent of confounding factors and BMI change rate," the researchers reported.
Longitudinal health records capture fluctuation in body mass index, which independently predicts the incidence of heart failure, the study stated.
Heart failure, a chronic and progressive condition characterized by the heart's inability to pump blood efficiently, poses a significant public health challenge worldwide. While obesity has long been recognized as a major risk factor for heart failure, the impact of fluctuations in body weight on cardiovascular health has garnered increasing attention in recent years.
Against the above background, Chang Liu, Department of Epidemiology Emory University Rollins School of Public Health Atlanta GA, and colleagues aimed to investigate the association between BMI variability and incident HF.
In the UK Biobank, a prospective cohort was established after excluding participants with prevalent HF or cancer at enrollment. 99 368 White participants with ≥3 BMI measures during >2 years preceding enrollment were included, with a median follow-up of 12.5 years.
The within-participant variability of body mass index was evaluated using standardized SD and coefficient of variation. The association of BMI variability with incident HF was evaluated using Fine and Gray's competing risk model, adjusting for confounding factors and participant-specific rate of BMI change.
The researchers found that higher BMI variability measured in both SD and coefficient of variation was significantly associated with higher risk in HF incidence (SD: hazard ratio [HR], 1.05; coefficient of variation: HR, 1.07).
The findings showed that BMI fluctuation is an independent predictor of heart failure incidence with consistent associations across risk factor subgroups.
The research underscores the need for exploring the mechanisms driving longitudinal BMI changes and their specific associations with heart failure subtypes.
"Future studies focusing on the underlying mechanisms and drivers of longitudinal body mass index change could lead to new insights into weight management strategies for heart failure prevention and intervention," the researchers concluded.
Reference:
Liu C, Chiang Y, Hui Q, Zhou JJ, Wilson PWF, Joseph J, Sun YV. High Variability of Body Mass Index Is Independently Associated With Incident Heart Failure. J Am Heart Assoc. 2024 May 7;13(9):e031861. doi: 10.1161/JAHA.123.031861. Epub 2024 Apr 30. PMID: 38686888.