Waist size may predict heart failure risk far better than BMI, study reveals

A new study has found that waist measurement could be a far better indicator of heart failure risk than BMI. Researchers discovered that central obesity, particularly around the midsection, strongly links to higher chances of developing the condition. The findings suggest doctors may need to rethink how they assess patients' heart health.

The study focused on Black adults but relied on biological processes seen across different groups. It revealed that visceral fat—fat stored deep in the abdomen—plays a key role in increasing heart failure risk. Waist circumference and waist-to-height ratio proved especially useful in identifying this dangerous fat distribution.

Inflammation was another major factor. High levels of hs-CRP, a marker for systemic inflammation, accounted for about 25% of the risk tied to central obesity. Unlike BMI, which showed no clear connection to heart failure, waist size emerged as a far stronger predictor. Medical guidelines have already begun shifting in this direction. Since 2013, the American Heart Association (AHA) has included waist circumference in obesity assessments. A 2022 AHA statement highlighted that larger waists (over 102 cm for men, 88 cm for women) raise heart failure risk, regardless of BMI. The World Health Organization's 2023 updates also reinforced using waist measurements alongside BMI for better risk evaluation.

The results could change how doctors screen for heart failure risk. By prioritising waist size over BMI, they may identify high-risk patients more accurately. However, further studies in broader populations are still needed to confirm these findings across different groups.