New research proposed in 2025 in Heart Failure shows that waist circumference to height ratios have higher predictors of heart failure risk compared to traditional body mass index measurements. The study, conducted by researchers at Lund University in Sweden, shows that the total weight of fat distributed in the body is greater than the overall body weight when assessing cardiovascular health risks.
The results presented today at the European Society of Cardiology at the scientific conference in Belgrade, Serbia may have a significant impact on how doctors screen patients for risk of heart failure.
Beyond BMI: Better measure of harmful fats
For decades, body mass index (BMI) has been the standard measure of obesity in clinical settings. However, it cannot explain where fat accumulates in the body, which is an important difference when assessing health risks.
“BMI is the most common measure of obesity, but it is influenced by factors such as gender and race and does not take into account the distribution of body fat,” explains Dr. Amra Jujic from Lund University. “The waist ratio is considered a stronger measure of central obesity, i.e. harmful deposition of fat around internal organs.”
This central obesity is particularly dangerous to accumulate fat around the abdomen and internal organs compared to fat distributed elsewhere in the body.
Research: Following patients for more than ten years
The research team followed 1,792 participants in the Malmö Prevention Program, with a median of 12.6 years. At the beginning of the study, participants ranged from 45 to 73 years old, and the researchers strategically selected individuals, so about one-third of the blood sugar levels were normal, with glucose fasting or diabetes impaired.
During the follow-up period, 132 participants suffered from heart failure. When analyzing the data, the researchers found that even after adjusting for other factors, a higher waist ratio was significantly associated with an increased risk of heart failure.
These numbers tell a fascinating story:
- The risk of heart failure increased by 34% for each standard deviation of increased waist circumference ratio.
- Compared to lower tertiles
- The median waist circumference ratio in the study population was 0.57, especially higher than the recommended cutoff value of 0.5
When is your waist too big?
What makes the waist ratio particularly useful is its simplicity. Unlike BMI where BMI requires weight and height calculations, the waist to height guide is simple.
“The waist size is less than half your height,” said study co-author Dr. John Molvin of Lund University and Malmö University Hospital.
For example, a person with a height of 5’8″ (68″ should have a waist circumference of less than 34″ to maintain a healthy ratio below 0.5.
Why is this measurement important?
The importance of this study is more than just providing another indicator of health. It may change the identification of patients who can benefit from targeted interventions.
Interestingly, previous studies have shown a contradictory relationship between BMI and heart failure outcomes – some studies have shown that patients with higher BMI sometimes perform better after developing heart failure, a phenomenon not observed by waist circumference to height measurements.
The findings of the study suggest that waist circumference ratios are particularly valuable for identifying patients who may benefit from obesity treatments that specifically reduce the risk of heart failure.
Is measuring your waist as routine as checking your blood pressure during a physical examination? Such research suggests that maybe it should be.
expect
The research team did not stop here. “Our next step is to study whether waist-circumference ratios can predict heart failure and other cardiac metabolic diseases in larger cohorts,” Dr. Malvin said.
These findings arrive at a critical moment as heart failure affects millions worldwide and obesity rates continue to rise worldwide. Having more precise tools to identify the most risky tools can help clinicians intervene in prevention strategies earlier.
For the average person, the information seems clear: focusing on waist circumference relative to height (rather than just overall weight) may provide important clues to heart health risks. Although BMI provides some insights, the body seems to carry much larger fat than previously known in clinical practice.
As researchers continue to explore this relationship, simple measurements that compare waist circumference to height may become an increasingly important part of routine health assessments and strategies to prevent heart failure.
If our report has been informed or inspired, please consider donating. No matter how big or small, every contribution allows us to continue to provide accurate, engaging and trustworthy scientific and medical news. Independent news takes time, energy and resources – your support ensures that we can continue to reveal the stories that matter most to you.
Join us to make knowledge accessible and impactful. Thank you for standing with us!
