{"id":7875,"date":"2025-07-12T09:31:29","date_gmt":"2025-07-12T06:31:29","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=7875"},"modified":"2025-07-12T09:31:29","modified_gmt":"2025-07-12T06:31:29","slug":"is-it-time-to-replace-bmi","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/is-it-time-to-replace-bmi\/","title":{"rendered":"Is It Time to Replace BMI?"},"content":{"rendered":"
Is It Time to Replace BMI?<\/div>\n
<\/div>\n
Facts and Fallacies of obesity & Body Composition in Heart Failure<\/div>\n
<\/div>\n
Published : JACC: Heart Failure \u2013 June 2025<\/div>\n
By: Dr. Melana Yuzefpolskaya, Dr. Paolo C. Colombo<\/div>\n
<\/div>\n
7 Key Facts Everyone Should Know:<\/div>\n
<\/div>\n
1. Heart failure with preserved ejection fraction (HFpEF) is now more common than HFrEF \u2014 and obesity plays a bigger role in HFpEF.<\/span><\/div>\n
2. Though obesity is a known risk factor for heart disease, studies have shown that overweight heart failure patients sometimes have better outcomes \u2014 a puzzling pattern called the \u201cobesity paradox.\u201d<\/span><\/div>\n
3. This paradox may be due to the limitations of BMI, which doesn\u2019t distinguish between fat vs muscle or show where fat is stored.<\/span><\/div>\n
4. Fat Distribution and Risk<\/span><\/div>\n
\u2022 Visceral fat (around organs) is more harmful than subcutaneous fat due to proinflammatory effects.<\/span><\/div>\n
\u2022 Metrics like waist circumference, waist-to-hip ratio, and waist-to-height ratio better reflect risk.<\/span><\/div>\n
\u2022 UK NICE recommends waist-to-height ratio over BMI.<\/span><\/div>\n
\u2022 Imaging (CT, MRI) offers precise fat distribution data but lacks standardized cutoffs.<\/span><\/div>\n
5. Sarcopenia in HF<\/span><\/div>\n
\u2022 Present in ~20% of HF patients; strong predictor of mortality.<\/span><\/div>\n
\u2022 Defined by:<\/span><\/div>\n
1. Low muscle strength (e.g., grip strength)<\/span><\/div>\n
2. Low muscle quantity\/quality<\/span><\/div>\n
3. Poor physical performance<\/span><\/div>\n
\u2022 Preferred assessment: DEXA scan (with validated sex-specific cutoffs).<\/span><\/div>\n
\u2022 Other tools: BIA, CT, MRI.<\/span><\/div>\n
6. A major meta-analysis of over 36,000 HF patients found:<\/span><\/div>\n
\u2022 Low muscle mass = higher mortality<\/span><\/div>\n
\u2022 High subcutaneous fat = potentially protective<\/span><\/div>\n
\u2022 Visceral fat = worse outcomes\u00a0<\/span><\/div>\n
7. New weight-loss drugs (like semaglutide and tirzepatide) are effective but can also lead to loss of muscle mass \u2014 up to 25% of the total weight lost \u2014 which may be harmful in older or frail patients with HF.<\/span><\/div>\n
<\/div>\n
Takeaway: BMI is an outdated tool for assessing health risk in heart failure. A deeper look at muscle mass, fat distribution, and functional strength gives a much clearer picture of patient risk \u2014 and should guide future care.<\/div>\n
<\/div>\n
https:\/\/www.jacc.org\/doi\/10.1016\/j.jchf.2025.05.003<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

Is It Time to Replace BMI? Facts and Fallacies of obesity & Body Composition in Heart Failure Published : JACC: Heart Failure \u2013 June 2025 By: Dr. Melana Yuzefpolskaya, Dr. Paolo C. Colombo 7 Key Facts Everyone Should Know: 1. Heart failure with preserved ejection fraction (HFpEF) is now more common than HFrEF \u2014 and […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-7875","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7875","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=7875"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7875\/revisions"}],"predecessor-version":[{"id":7876,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7875\/revisions\/7876"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=7875"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=7875"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=7875"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}