Editorial Obesity and heart failure prognosis: paradox or reverse epidemiology?

This editorial refers to ‘Effect of obesity and being overweight on long-term mortality in congestive heart failure: influence of left ventricular systolic function’ † by F. Gustafsson et al., on page 58 Obesity is a problem reaching epidemic proportions in westernized society and is a major cause of preventable death.1 Obesity has many adverse effects on coronary artery disease (CAD) risk factors and is probably an inde-pendent risk factor for CAD events. Epidemiological studies have clearly shown a strong relationship between obesity and increased risk of cardiovascular disease and mortality in the general population,1,2 although in some of these studies a ‘J-shaped ’ or ‘U-shaped ’ curve has been present, meaning that those individuals with low body mass index (BMI) also hav