Abstract P581: Body Mass Index Variability in Relation to Heart Failure and Outcomes

Introduction: Heart failure (HF) is a disease with high morbidity and mortality, and affects an estimated total of 6.2 million HF patients in the US. Obesity is an established risk factor for HF, and fluctuation in body mass index (BMI) has shown a negative effect in health. Hypothesis: We assessed the hypothesis that BMI variability is associated with incident HF. Methods: This study used data from the UK Biobank, which is a prospective cohort study with a median follow-up of 12.5 years. After excluding prevalent HF or cancer at enrollment, a total of 99,368 White participants with ≥ 3 BMI measures from primary care records within > 2 years before and at enrollment were included. The within-participant variability of BMI was evaluated using standard deviation (SD) and coefficient of variation (CV), which were converted to z scores for further analysis. HF prevalence and incidence were ascertained based on in-patient Hospital Episode Statistics using ICD-9 and -10 codes and self-report at enrollment. The association of BMI variability with incident HF was assessed using Fine and Gray's competing risk model, treating death events obtained from the National Death Registry as competing risk. Two multi-variate models were used: Model 1 adjusted for age, sex, smoking history, alcohol consumption, diabetes, hypertension, history of heart attack or stroke, lipids, estimated glomerular filtration rate; Model 2 additionally adjusted for mean BMI across multiple measures per individual. Sex-stratified analyses were also conducted. Results: The cohort was 43% male, with mean age 57.5 (SD 7.8) years. A total of 3,406 incident HF cases were observed during the follow-up. Per SD higher in BMI variability measured in SD and CV were associated with higher risk in HF incidence, with stronger associations observed among females, Figure 1 . Conclusions: BMI fluctuation is linked with HF incidence. Future studies are warranted to explore the mechanisms in changes of BMI such as body composition, and the possible causal pathways leading to HF.