Overview
- The Journal of the American College of Cardiology published a pooled analysis Tuesday that combined 15 prospective cohorts and about 259,000 people to compare waist circumference (WC) and waist‑to‑hip ratio (WHR) with body mass index (BMI) for nine cardiovascular outcomes.
- Standard cutoffs (WC >88 cm for women and >102 cm for men; WHR >0.85 for women and >0.90 for men) identified that 5% of people with normal BMI had high WC and 18% had high WHR, and those with high central adiposity faced roughly 15%–50% higher risk across most outcomes over ~20 years of follow‑up.
- The analysis found that some people labeled obese by BMI but with small waists had cardiovascular risks similar to normal‑weight peers, and among people with obesity elevated WC accounted for large shares of events (about 49% of heart failure, 46% of atrial fibrillation, and 36% of coronary heart disease deaths).
- JACC editors and study authors say clinicians should consider adding WC or WHR to routine risk assessment because these simple tape‑measure tests reduce misclassification of risk across BMI categories.
- The study is observational and used a single baseline waist measure and lacked data on physical activity, diet and genetic risk, so researchers call for work to define measurement protocols, test whether reducing central adiposity lowers events, and show how to add these measures into risk models.