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Background & Aims: Many studies have suggested that obese patients with chronic heart failure have a better prognosis than leaner patients. The main purpose of this study was to assess the prognostic value of body mass index in patients with chronic heart failure, independently of other poor prognosis parameters., Methods: This retrospective study included 405 heart failure patients. Anthropometric, body composition, clinical, biochemical, and echocardiographic data were collected from all patients. Patients were classified as: underweight (<20 kg/m(2)), normal (20-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (≥30 kg/m(2)). The endpoints were all-cause and cardiovascular mortality., Results: Cox regression analysis on all-cause mortality showed that normal weight patients were at significantly lower risk of death [RR = 0.231 (CI(95%) 0.085-0.627)] as compared with obese patients, while underweight and overweight categories did not show a significantly different risk compared with the reference category. Age, gender, ejection fraction, systolic heart failure, angiotensin II receptor blockers use, hemoglobin levels, and handgrip strength were independent predictors of all-cause mortality. Cardiovascular deaths showed the same trend., Conclusion: A lower body mass index does not predict all-cause and cardiovascular mortality among chronic heart failure patients, independently of other nutritional, body composition, and clinical status parameters., (2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: Elevated blood pressure at a young age is a predictor of blood pressure elevation later in life and has been associated with being overweight. However, it seems that there are other factors related to hypertension in childhood., Objective: To determine the anthropometric, physical activity, and dietary factors associated with both systolic and diastolic hypertension in a group of Mexican school-aged children., Design: In this cross-sectional descriptive study, blood pressure, anthropometrics, physical activity, and dietary intake (assessed with a multiple-pass 24-hour dietary recall) evaluations were performed on school-aged children from September 2005 to July 2006., Subjects: Children aged 8 to 10 years (626 boys and 613 girls) from a convenience sample of 23 public schools of low socioeconomic status in Mexico City were included. Systolic and diastolic hypertension were defined as blood pressure > or = 95th percentile for age, sex, and height, without diastolic or systolic prehypertension or hypertension, respectively. Mixed hypertension was defined as the presence of both systolic and diastolic hypertension., Statistical Analysis: Descriptive statistics, chi(2) tests, analysis of variance, post hoc analysis with Bonferroni method, and logistic regression analysis were performed. Continuous variables are presented as mean+/-standard deviation, categorical variables as percentages, and the association measures as adjusted odds ratios (ORs). A P value < 0.05 was considered statistically significant, and 95% confidence intervals were calculated for adjusted ORs., Results: The dietary intake analysis showed that both boys and girls had low fiber intake (< 25 g/day) as well as an excessive mean consumption of total and saturated fat (> 35% and > 10% of daily energy, respectively). From the total group of children, 3.6% had systolic hypertension, 14.2% diastolic hypertension, and 22.8% mixed hypertension. The higher values of weight, body mass index, waist circumference, and prevalence of overweight and obesity were more commonly seen among children with mixed hypertension, followed by children in the systolic group. Subjects with diastolic and mixed hypertension had an elevated intake of dietary total fat (37.7% and 38.2% of daily energy intake, respectively). Moreover, an adjusted OR of 1.06 (95% confidence interval 1.01 to 1.11) for systolic hypertension per increase of 1 cm in waist diameter was found and total fat intake > 35% of the daily energy showed an adjusted OR of 2.61 (95% confidence interval 1.27 to 5.36) for diastolic hypertension., Conclusions: In a sample of Mexican children of low socioeconomic status, the prevalence of hypertension was high. Waist circumference was the main factor associated with systolic hypertension, and higher intake of total fat was related to diastolic hypertension.

Background: Heart failure (HF) patients with hemodilutional anemia had a worse prognosis than those with true anemia. Volume overload (VO) in anemic patients must be identified in order to select the best treatment., Method: We assessed the prevalence of anemia and VO in systolic and diastolic HF patients, and its effects on clinical status, body composition, and quality of life (QOL). Anemia was defined according to the OMS criteria and VO was assessed by bioelectrical impedance analysis (BIA). Echocardiography variables were also obtained., Results: We studied 132 HF patients, 59.1% with systolic and 40.9% with diastolic HF. Anemia was present in 29.5% patients with systolic and 24.1% with diastolic HF (P=0.7). Anemic patients in the systolic HF group tend to be worse functional class than the non-anemic subjects; moreover, in both groups of cardiac dysfunction, the anemic patients had less grip strength, lower body mass index (BMI) and waist and hip circumferences, and a higher percentage of extracellular water (ECW), a higher proportion of patients with total serum cholesterol concentration below the 25th percentile, and a lower serum albumin. When patients were divided in 4 subgroups according to the presence of anemia and/or VO, we observed that VO affected the body composition not only through lower BMI, and waist and hip circumferences but also through a lower phase angle. Systolic HF patients with anemia and VO had the highest dimension of left atrium and pulmonary artery pressure (PAP) levels., Conclusion: Anemia is common in HF and its prevalence is similar in systolic and diastolic HF patients. Anemia was associated to VO, less grip strength and body composition abnormalities; however, VO was related to more severe body composition and echocardiographic abnormalities, as well as to an impairment of QOL. So that, it is important to differentiate between those who have anemia associated to VO and those who have true anemia.