ADIPOQ and heart failure: Increased circulating levels of adiponectin are not always indicative of improvements in health or reductions in cardiovascular risk: the so-called “adiponectin paradox” refers to the observation that while adiponectin mediates a variety of essentially beneficial effects and levels of adiponectin correlate positively with better long term cardiovascular outcomes in young healthy populations they also correlate with increased risk of premature death in high-risk populations, especially older patients or those with ischemic heart disease, heart failure or renal failure25.