Rethinking HFpEF: Targeting obesity as the root cause

Prof Andrew Sindone AM

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Prof Andrew Sindone AM

Cardiologist; Director of the Heart Failure Unit and Department of Cardiac Rehabilitation, Concord Hospital; Head, Department of Cardiology, Ryde Hospital

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Obesity has become one of the defining health challenges of modern Australia. Currently, around two-thirds of Australians aged over 18, approximately 13 million adults,1 are either overweight or obese.

This trend continues to rise, contributing to an ever-growing burden of chronic disease. Beyond its well-known associations with diabetes and hypertension, obesity has now emerged as a leading driver of heart failure with preserved ejection fraction (HFpEF), a form of heart failure that has long been considered difficult to diagnose and even harder to treat.

Recent years have brought a surge in our understanding of the complex interplay between adiposity, cardiovascular mechanics, and systemic inflammation. Alongside these insights, new therapeutic strategies, including incretin-based agents, are reshaping the management of patients with obesity-related HFpEF

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References

  1. Australian Institute of Health and Welfare. Overweight and obesity. Available at: https://www.aihw.gov.au/reports/overweight-obesity/overweight-and-obesity/contents/summary [accessed January 2026].
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  22. Chopra V, et al. Heart Lung Circ. 2025;34(7):e55-e82.

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Prof Andrew Sindone AM

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Prof Andrew Sindone AM

Cardiologist; Director of the Heart Failure Unit and Department of Cardiac Rehabilitation, Concord Hospital; Head, Department of Cardiology, Ryde Hospital

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