Even a few extra pounds add to risk of heart-felt problems

From wire reports

Researchers have found another reason to watch your waistline: Being even modestly overweight increases the chances of developing heart failure.

Extreme obesity has already been linked to heart failure, but whether that was true for milder weight problems wasn't as firmly established.

A study of 5,881 men and women published in Thursday's New England Journal of Medicine showed that the risk of heart failure is double in obese people and 34 percent higher in those overweight, compared with those of normal weight.

Researchers also determined that the risk rose gradually with weight levels.

"We have one more reason for people who are obese to lose weight and people who are overweight to move toward normal weight," said one of the researchers, Dr. Ramachandran Vasan of Boston University School of Medicine.

Previously, researchers were aware that severe obesity was an independent risk factor for heart failure, but the new data show that being even moderately overweight increases one's chances of developing the condition - and the more overweight someone is, the greater the risk.

Obesity alone accounts for 14 percent of cases of heart failure in women and 11 percent in men, according to estimates in the study, which appears in Thursday's issue of the New England Journal of Medicine.

Obesity "is almost a primordial risk factor," said Claude Lenfant, director of the National Heart, Lung and Blood Institute. "If you have it ... you are going to be pulled to all these problems, and eventually ... to heart failure."

Obesity has become epidemic in the United States in recent years, with 61 percent of adults classified as overweight or obese on the basis of their body mass index (BMI), a ratio of weight to height.

At the same time, the incidence of heart failure has risen during the last quarter-century because of improved survival from heart attacks, the aging of the U.S. population and other factors. About 4.8 million Americans are living with heart failure, and the condition causes about 51,000 deaths annually.

The study "ups the ante for how much of a health risk it is to be obese," said David Cummings, an obesity researcher.

Because heart failure develops gradually, it most commonly affects people over age 60. It can occur when the heart's muscle wall has been damaged, often by heart attacks, and cannot contract strongly enough to pump blood efficiently, or when the wall has become so stiff and thick that the heart does not fill sufficiently with blood between beats. Sometimes both problems contribute.

Symptoms of heart failure usually include breathlessness when sleeping or lying flat, ankle swelling, difficulty breathing with minor exertion, a nighttime cough and a fast heart rate.

"It's a bad condition to have," said Ramachandran Vasan of Boston University School of Medicine, a senior investigator with the Framingham Heart Study and principal author of the new study. "Although we have excellent medications ... the general outcome is grim. The five-year survival is often less than 50 percent." In the study, researchers monitored the characteristics, habits and long-term health of 5,881 residents of Framingham, Mass. Their average age was 55 at the start, and they were followed for an average of 14 years. Heart failure developed in 496 participants *--* 258 women and 238 men.