Uncorrected obesity is considered as a significant independent risk factor for the ever-rising preva-lence for cardiovascular diseases.Body mass index(BMI)is a frequently employed clinical indicator for obesity.Nonetheless,clinical studies have demonstrated that heart failure patients with overweight(BMI 25.0-29.9 kg/m2)or obesity(BMI＞30 kg/m2)possess a surprisingly better prognosis compared with those patients with nor-mal weight(BMI 18.5-24.9 kg/m2)or low weight(BMI＜18.5 kg/m2).This clinical phenomenon is commonly perceived as the obesity paradox,which has drawn much attention by physicians and scientists.It has been sug-gested that conventional clinical evaluation of obesity,relying solely on BMI as a measure,may be subject to limi-tations due to the presence of confounding factors and selection bias.Nevertheless,numerous epidemiological studies have consistently demonstrated a paradoxical improvement in cardiovascular disease prognosis associated with higher BMI levels.In this review,we aim to provide an overview of the factors influencing the obesity para-dox,explore potential underlying mechanisms,and discuss its clinical implications.
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