{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:28:59Z","timestamp":1789468139583,"version":"build-2803163510"},"reference-count":34,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babe\u0219 University of Medicine and Pharmacy Timi\u0219oara"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: We compared BMI and LDL-C across database-defined reference controls, hypertension, and preserved-EF ischemic heart disease without assuming HFpEF. Methods: This single-center retrospective cross-sectional study included 128 adults (20 controls, 46 with hypertension, and 62 in the preserved-EF ischemic group). Analyses included nonparametric tests, multinomial regression, clinical-group models with and without statin adjustment, and a post hoc common-age sensitivity analysis. Results: Median BMI was 25.89, 28.25, and 29.00 kg\/m2, respectively (p &lt; 0.001); median LDL-C was 86.0, 109.5, and 100.0 mg\/dL (p = 0.055), alongside statin use of 0%, 50.0%, and 87.1%. Per 5 kg\/m2 higher BMI, the adjusted RRR for preserved-EF ischemic versus control status was 3.94 (95% CI 1.60\u20139.71; p = 0.003) and remained 3.48 (95% CI 1.35\u20138.97; p = 0.010) among participants aged 40\u201368 years. In clinical-group models, BMI estimates were similar without and with statin adjustment (OR 1.76 and 1.89); LDL-C was not independently associated with preserved-EF ischemic status. Conclusions: BMI differed more consistently across groups than treated, contemporaneous LDL-C. These associations are imprecise and describe group status; they do not establish causation, progression, prospective HF risk, or HFpEF.<\/jats:p>","DOI":"10.3390\/jcm15187096","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:09:51Z","timestamp":1789387791000},"page":"7096","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body Mass Index and LDL Cholesterol Across Controls, Hypertension, and Ischemic Heart Disease with Preserved Ejection Fraction: A Single-Center Retrospective Cross-Sectional Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Gheorghe","family":"Stoichescu-Hogea","sequence":"first","affiliation":[{"name":"Department of Cardiology, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy of Timi\u0219oara, Eftimie Murgu Square 2, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Laura","family":"Craciun","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy of Timi\u0219oara, Eftimie Murgu Square 2, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6025-5998","authenticated-orcid":false,"given":"Ana-Maria","family":"Pah","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy of Timi\u0219oara, Eftimie Murgu Square 2, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7868-9266","authenticated-orcid":false,"given":"Cristiana Adina","family":"Avram","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy of Timi\u0219oara, Eftimie Murgu Square 2, 300041 Timi\u0219oara, 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Card. Fail."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_3","first-page":"e895","article-title":"2022 AHA\/ACC\/HFSA Guideline for the Management of Heart Failure","volume":"145","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1001\/jama.2023.2020","article-title":"Heart Failure with Preserved Ejection Fraction: A Review","volume":"329","author":"Redfield","year":"2023","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jacc.2013.02.092","article-title":"A Novel Paradigm for Heart Failure with Preserved Ejection Fraction: Comorbidities Drive Myocardial Dysfunction and Remodeling through Coronary Microvascular Endothelial Inflammation","volume":"62","author":"Paulus","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1161\/CIRCULATIONAHA.114.010637","article-title":"Phenomapping for Novel Classification of Heart Failure with Preserved Ejection Fraction","volume":"131","author":"Shah","year":"2015","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1161\/CIRCULATIONAHA.116.026807","article-title":"Evidence Supporting the Existence of a Distinct Obese Phenotype of Heart Failure with Preserved Ejection Fraction","volume":"136","author":"Obokata","year":"2017","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3434","DOI":"10.1093\/cvr\/cvac120","article-title":"Obesity and Heart Failure with Preserved Ejection Fraction: New Insights and Pathophysiological Targets","volume":"118","author":"Borlaug","year":"2022","journal-title":"Cardiovasc. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1161\/CIRCULATIONAHA.118.034646","article-title":"A Simple, Evidence-Based Approach to Help Guide Diagnosis of Heart Failure with Preserved Ejection Fraction","volume":"138","author":"Reddy","year":"2018","journal-title":"Circulation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3297","DOI":"10.1093\/eurheartj\/ehz641","article-title":"How to Diagnose Heart Failure with Preserved Ejection Fraction: The HFA\u2013PEFF Diagnostic Algorithm","volume":"40","author":"Pieske","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e029062","DOI":"10.1161\/JAHA.122.029062","article-title":"Body Composition and Risk of Incident Heart Failure in 1 Million Adults: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies","volume":"12","author":"Oguntade","year":"2023","journal-title":"J. Am. Heart Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e002883","DOI":"10.1161\/CIRCHEARTFAILURE.115.002883","article-title":"Risk Factors for Incident Hospitalized Heart Failure with Preserved versus Reduced Ejection Fraction in a Multiracial Cohort of Postmenopausal Women","volume":"9","author":"Eaton","year":"2016","journal-title":"Circ. Heart Fail."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.jchf.2018.05.018","article-title":"The Association of Obesity and Cardiometabolic Traits with Incident HFpEF and HFrEF","volume":"6","author":"Savji","year":"2018","journal-title":"JACC Heart Fail."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2345","DOI":"10.1161\/CIRCULATIONAHA.109.830984","article-title":"Relations of Lipid Concentrations to Heart Failure Incidence: The Framingham Heart Study","volume":"120","author":"Velagaleti","year":"2009","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1161\/CIRCHEARTFAILURE.112.000093","article-title":"Association of Lipids with Incident Heart Failure among Adults with and without Diabetes Mellitus: Multi-Ethnic Study of Atherosclerosis","volume":"6","author":"Ebong","year":"2013","journal-title":"Circ. Heart Fail."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1093\/eurheartj\/ehx144","article-title":"Low-Density Lipoproteins Cause Atherosclerotic Cardiovascular Disease. 1. Evidence from Genetic, Epidemiologic, and Clinical Studies","volume":"38","author":"Ference","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS Guidelines for the Management of Dyslipidaemias: Lipid Modification to Reduce Cardiovascular Risk","volume":"41","author":"Mach","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies","volume":"370","author":"Altman","year":"2007","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1161\/CIRCHEARTFAILURE.112.972828","article-title":"Predictors of New-Onset Heart Failure: Differences in Preserved versus Reduced Ejection Fraction","volume":"6","author":"Ho","year":"2013","journal-title":"Circ. Heart Fail."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1001\/jama.2015.17346","article-title":"Effect of Caloric Restriction or Aerobic Exercise Training on Peak Oxygen Consumption and Quality of Life in Obese Older Patients with Heart Failure with Preserved Ejection Fraction: A Randomized Clinical Trial","volume":"315","author":"Kitzman","year":"2016","journal-title":"JAMA"},{"key":"ref_21","first-page":"e984","article-title":"Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association","volume":"143","author":"Poirier","year":"2021","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1056\/NEJMoa2306963","article-title":"Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity","volume":"389","author":"Kosiborod","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1056\/NEJMoa2313917","article-title":"Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes","volume":"390","author":"Kosiborod","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1056\/NEJMoa2410027","article-title":"Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity","volume":"392","author":"Packer","year":"2025","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.ijcard.2022.05.018","article-title":"Association of Body Mass Index and Prognosis in Patients with HFpEF: A Dose\u2013Response Meta-Analysis","volume":"361","author":"Li","year":"2022","journal-title":"Int. J. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.3390\/nu5041218","article-title":"Dyslipidemia in Obesity: Mechanisms and Potential Targets","volume":"5","author":"Klop","year":"2013","journal-title":"Nutrients"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/S2213-8587(19)30084-1","article-title":"Visceral and Ectopic Fat, Atherosclerosis, and Cardiometabolic Disease: A Position Statement","volume":"7","author":"Neeland","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1467-789X.2011.00952.x","article-title":"Waist-to-Height Ratio Is a Better Screening Tool than Waist Circumference and BMI for Adult Cardiometabolic Risk Factors: Systematic Review and Meta-Analysis","volume":"13","author":"Ashwell","year":"2012","journal-title":"Obes. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1038\/ijo.2008.87","article-title":"BMI-Related Errors in the Measurement of Obesity","volume":"32","author":"Rothman","year":"2008","journal-title":"Int. J. Obes."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3785","DOI":"10.2337\/db14-0385","article-title":"Distinct Developmental Profile of Lower-Body Adipose Tissue Defines Resistance against Obesity-Associated Metabolic Complications","volume":"63","author":"Pinnick","year":"2014","journal-title":"Diabetes"},{"key":"ref_31","first-page":"e51698","article-title":"The Influence of Anthropometrics on Cardiac Mechanics in Healthy Women with Opposite Obesity Phenotypes (Android vs. Gynoid)","volume":"16","author":"Sonaglioni","year":"2024","journal-title":"Cureus"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Cholesterol Treatment Trialists\u2019 Collaboration, Baigent, C., Blackwell, L., Emberson, J., Holland, L.E., Reith, C., Bhala, N., Peto, R., Barnes, E.H., and Keech, A. (2010). Efficacy and Safety of More Intensive Lowering of LDL Cholesterol: A Meta-Analysis of Data from 170,000 Participants in 26 Randomised Trials. Lancet, 376, 1670\u20131681.","DOI":"10.1016\/S0140-6736(10)61350-5"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1001\/jama.2016.13985","article-title":"Association between Lowering LDL-C and Cardiovascular Risk Reduction among Different Therapeutic Interventions: A Systematic Review and Meta-Analysis","volume":"316","author":"Silverman","year":"2016","journal-title":"JAMA"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e1154","DOI":"10.1161\/CIR.0000000000001457","article-title":"2026 ACC\/AHA\/AACVPR\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"153","author":"Blumenthal","year":"2026","journal-title":"Circulation"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7096\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T08:55:32Z","timestamp":1789462532000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,13]]},"references-count":34,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15187096"],"URL":"https:\/\/doi.org\/10.3390\/jcm15187096","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,13]]}}}