Overview
- The Journal of the American College of Cardiology published a pooled analysis on Tuesday that used data from about 259,351 people and a median 20-year follow-up to compare waist measures with BMI for nine heart outcomes.
- Waist circumference and waist-to-hip/height ratios identified people with normal BMI who carried excess abdominal (visceral) fat; 5% had high waist circumference and 18% had high waist-to-hip ratio within the normal-BMI group.
- Among people with normal or overweight BMI, high central adiposity was tied to a 15%–50% higher risk of most cardiovascular events over ~20 years, while some people labeled obese by BMI but with low waist measures had similar risk to normal-weight peers.
- For people with obesity, elevated waist circumference explained a large share of events: about 49% of heart failure, 46% of atrial fibrillation, and 36% of coronary heart disease deaths in the study sample.
- Authors and JACC editors urged adding simple waist measurements to routine risk assessment but noted limits including a single baseline waist measure, no data on activity, diet or genetics, and the study’s observational design which means guideline changes will likely await further validation and implementation research.