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Getting the latest healthcare news for you
Getting the latest healthcare news for you
Forget BMI — your waist size may tell a more accurate story about your heart health. A large study of over 260,000 people found that waist circumference and waist-to-hip ratio better predict cardiovascular risk than BMI alone, even in people considered "normal weight." Clinicians are now being urged to measure central adiposity across all BMI categories when assessing heart disease risk.
BMI has long been the go-to metric for gauging obesity and cardiovascular risk — but a major new study says it's leaving too many high-risk patients undetected. Published in the Journal of the American College of Cardiology, the research found that waist circumference (WC) and waist-to-hip ratio (WHR) are significantly better at predicting cardiovascular disease (CVD) risk than BMI alone, and can reclassify risk across the entire weight spectrum.
The study, led by researchers at Johns Hopkins, pooled data from 15 prospective cohorts and tracked nine cardiovascular and mortality outcomes over a median of 20 years. The core finding: people with "normal" BMI but high WC or WHR faced meaningfully elevated heart disease risk — while some people classified as obese by BMI actually had lower risk due to favorable fat distribution.
By the Numbers:
Why it matters: BMI is quick and cheap, but it can't distinguish where fat is stored — and location matters enormously for heart health. Visceral (abdominal) fat drives insulin resistance, inflammation, and vascular dysfunction. Clinicians who rely solely on BMI risk missing high-risk patients in the "normal" weight category, and may over-flag lower-risk patients with obesity. Adding a simple waist measurement to routine visits could meaningfully sharpen cardiovascular risk assessment.
