Korean J Intern Med.  2025 May;40(3):357-370. 10.3904/kjim.2024.387.

Obesity and heart failure with preserved ejection fraction: focus on new drugs and future direction in medical treatment

• Kim SE
• Yoo BS

• KMID: 2567642
• DOI: http://doi.org/10.3904/kjim.2024.387

Abstract

Obesity is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and contributes through multiple pathophysiological pathways, including systemic inflammation, neurohormonal activation, and mechanical inhibition. The treatment of obesity has shown significant potential for improving HFpEF outcomes. Sodium-glucose cotransporter 2 inhibitors have emerged as effective treatments for improving symptoms and quality of life in patients with HFpEF while aiding in weight control. Furthermore, a recent demonstration of the clinical benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in HFpEF showed promising results in reducing weight loss, and improving symptoms and clinical outcomes. In this review article, we discuss the association between HFpEF and obesity, the emerging role of GLP-1 RAs, and future directions for medical therapies targeting obesity-associated HFpEF.

Keyword

Heart failure; Obesity; Glucagon-like peptide-1 receptor agonists