Nakamura T, Kamiya K, Matsunaga A, et al. - Via analysis of data from 2,224 patients aged ≥ 60 years with cardiovascular disease who were hospitalized between May 1, 2006 and January 31, 2018, researchers investigated whether gait speed influenced the obesity paradox in elderly cardiovascular disease individuals. In total, 283 patients died over a median follow-up period of 1.69 years. In the preserved gait speed group, higher BMI was correlated with favorable prognosis, but not in the slow gait speed group, following adjustments in other prognostic factors. In the preserved gait speed group and not in the slow gait speed group, adding BMI to the clinical model significantly raised the area under the receiver operating characteristic curve. In patients with cardiovascular disease with preserved gait vs in those with slow gait speed, higher BMI was consistently related to a favorable prognosis. In elderly patients with cardiovascular disease, physical frailty affected the obesity paradox.