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McMurray, Joanna Dobson, Salim Yusuf, Christopher B. Swedberg, on behalf of the CHARM Investigators; Weight loss and mortality risk in patients with chronic heart failure in the candesartan in heart failure: assessment of reduction in mortality and morbidity CHARM programme. Eur Heart J ; 29 21 : We investigated the change in weight over 6 months in patients in the Candesartan in Heart failure: Reduction in Mortality and morbidity CHARM programme, and its association with subsequent mortality deaths over a median The percentage weight loss over 6 months losx a highly significant monotonically increasing association with excess mortality, both for cardiovascular and for other causes of death.
Weight loss carried a particularly high risk in patients who were heagt lean at study entry. Findings were similar in the presence of dependent oedema, preserved or reduced LV ejection fraction, and treatment with candesartan, although weight loss was significantly less common on candesartan. The time-updated analyses revealed an even stronger link between weight loss and short-term risk of dying, i.
Weight gain had a more modestly increased short-term mortality risk. Hsart loss accelerates in the year prior to death. Weight loss and leanness are important predictors of poor prognosis in CHF. Being lean and losing weight is particularly bad. The detection of weight change, and particularly heary loss, should be considered as an adverse sign prompting further evaluation.
Several studies of heart failure HF populations have shown that leaner patients have a poor survival and obese patients with chronic HF CHF have no excess mortality risk. There have been previous informative studies of weight loss and mortality in HF patients. The main aim of this analysis in the Hearg programme was to assess and quantify the effect of weight loss on mortality. Previous publications describe the design and results of the CHARM programme. These were planned to be at baseline, 2, 4, 6 weeks, 6 months, and then every 4 months thereafter until a maximum of 42 months.
Actual timing of visits varied and was assigned to the planned visit when within failre week of the intended timing first two visitswithin 1 week before or 5 weeks after third visit or within 2 months of intended timing for the 6 month visit onwards. Height was recorded at baseline, enabling body mass index BMI to be calculated. Prognostic models have previously determined which baseline variables in this population are significantly related to mortality, and details of such variables are can weight loss reverse congestive heart failure therein.
Causes of death were determined by an independent adjudication committee using pre-specified criteria. A death was considered cardiovascular CV unless a specific non-CV cause was identified. For each patient, weights at 6 months and baseline visits were used to calculate the percentage change in weight at 6 months. A total of patients died, five were lost to follow-up before 6 months, and a further patients did not have a recorded weight at 6 months, which left patients deaths for analysis relating 6 month weight change to fwilure mortality risk.
This model included those baseline variables previously identified as predictors of mortality, 16 the randomized treatment candesartan or placeboand also the mean of the two measures of BMI at baseline and 6 months. The possible non-linearity of relationship of both percentage weight change and BMI to mortality risk was assessed by grouping them into eight and seven ordered categories, respectively. To assess the ongoing relationship of last recorded annual weight change to current mortality risk, a Cox model was used with two time-updated covariates for annual percentage weight change and BMI.
At the 14 month visit date, this was updated to the percentage weight change from 6 weeks to 14 months, again adjusted to an estimated 12 month rate. This variable was then updated at 18 months to the percentage weight change from 6 to 18 months, at 22 can weight loss reverse congestive heart failure to the percentage weight change from 10 to 22 months and so on throughout follow-up.
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Reversing congestive heart failure may be a reality for you. Yet reversing congestive heart failure often means reversing Or poor digestion? Or weight gain?. Reduction in Mortality and morbidity (CHARM) programme, Prognostic importance of weight loss in chronic heart failure Candesartan in heart failure. Video embedded · Reverse Your Heart Disease in 28 you can reverse your heart disease by eliminating the behaviors that have contributed to your Wedding Weight - Loss.