FREQUENCY OF CENTRAL OBESITY AND METABOLIC RISK FACTORS AND THEIR ASSOCIATION WITH HFrEF AND HFpEF IN PATIENTS PRESENTING TO A TERTIARY CARE HOSPITAL IN KARACHI

Abstract

Background: Heart failure (HF) is a significant public health problem including preserved (HFpEF) and reduced ejection fraction (HFrEF). The association of central obesity and metabolic risk factors is well established, but their synergistic effect within different types of HF is limited in Pakistan.

Objective: To determine the prevalence of central obesity and metabolic risk factors and their connection to HFpEF and HFrEF in patients presented in a tertiary care hospital in Karachi.

Methods: A six-month cross sectional study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi, involving 200 HF patients (age 18-70 years). Anthropometric, metabolic and echocardiographic parameters were recorded. Chi‑square, t‑tests, Pearson correlation, and binary logistic regression were used for the statistical analysis.

Results: Central obesity was present in 132 patients (66.0%), which was much more common among those suffering from HFpEF (80.4%) than HFrEF (53.7%; p < 0.001). The most commonly encountered cardiovascular risk factors included hypertension (71.0%), dyslipidemia (61.0%), and diabetes mellitus (48.0%). The logistic regression found that central obesity (OR = 6.31, 95% CI: 2.73–14.58, p < 0.001), diabetes mellitus (OR = 4.00, p = 0.001), hypertension (OR = 4.00, p = 0.001), and dyslipidemia (OR = 3.09, p = 0.005) independently predicted HFpEF.

Conclusion: Central obesity and cardiometabolic risk factors are very common in HF patients, especially in HFpEF. Central obesity was the most independent predictor. Clinical assessment should include routine screening for central obesity and metabolic risk factors for early risk stratification and targeted interventions.