disease (CVD). Leptin regulates energy homeostasis, is elevated in obesity, and

influences ventricular and vascular remodeling. We tested the hypothesis that leptin levels are

associated with greater risk of CHF, CVD, and mortality in elderly individuals.

years, 62% women) Framingham Study participants attending a routine examination at which

plasma leptin was assayed.

0.0001). On follow-up (mean 8.0 years), 129 (of 775 free of CHF) participants developed CHF,

187 (of 532 free of CVD) experienced a first CVD event, and 391 individuals died. In multivariable

Cox regression models adjusting for established risk factors, log-leptin was positively

associated with incidence of CHF and CVD (hazard ratio [HR] per SD increment 1.26 [95% CI

1.03–1.55] and 1.28 [1.09 –1.50], respectively). Additional adjustment for BMI nullified the

association with CHF (0.97 [0.75–1.24]) but only modestly attenuated the relation to CVD

low and high leptin levels.

leptin levels were associated with a greater risk of CHF and CVD, but leptin did not provide

incremental prognostic information beyond BMI. Additional investigations are warranted to

elucidate the U-shaped relation of leptin to mortality.