A new study has found that the waist-to-height ratio (WtHR) could be a better way to predict heart failure than the commonly used body mass index (BMI). The findings were presented at Heart Failure 2025, highlighting the potential of WtHR as a simple and effective measure for assessing heart health risks.
Obesity has long been linked to heart failure, a condition where the heart is unable to pump blood effectively, leading to symptoms like fatigue, shortness of breath, and fluid buildup. Traditionally, BMI has been the standard measure for obesity. BMI calculates body fat based on height and weight, but it does not reveal where fat is stored in the body.
This is important because fat stored around the abdomen, known as central obesity, is much more dangerous to heart health than fat in other areas. Central obesity is linked to higher risks of heart disease, diabetes, and heart failure. BMI also does not account for differences in body structure based on gender or ethnicity, which can make it less accurate for predicting health risks.
Dr. Amra Jujic from Lund University in Sweden, who presented the study, explained why they decided to explore WtHR instead of BMI. She pointed out that WtHR is a better measure of fat stored around the organs, which is known to cause more harm to the heart and blood vessels.
Unlike BMI, WtHR is not affected by gender or ethnic differences, making it a more reliable measure for different populations.
Also, some studies have shown that people with higher BMI sometimes have better heart failure outcomes, a phenomenon known as the “obesity paradox.” However, this paradox is not seen with WtHR, suggesting it may be a more straightforward measure of health risks.
The study involved 1,792 people from the Malmö Preventive Project, a large community-based health study. The participants were between 45 and 73 years old at the start of the study, with one-third of them having normal blood sugar levels, another third having prediabetes, and the final third diagnosed with diabetes.
Researchers followed these participants for an average of 12.6 years to track the development of heart failure.
The average age of the participants was 67 years, and nearly 30% were women. The average WtHR was measured at 0.57, meaning that their waist size was 57% of their height.
For example, a person who is 170 cm tall would have an average waist size of about 97 cm. Health experts generally consider a WtHR of 0.5 or less to be ideal, as anything above that increases the risk of heart and metabolic problems.
Over the course of the study, 132 people developed heart failure. When the researchers analyzed the data, they found that a higher WtHR was linked to a greater risk of heart failure. For every increase in WtHR, the risk of heart failure went up by 34%, even when other health factors were considered.
To understand this better, the researchers divided the participants into four groups based on their WtHR levels. Those with the highest WtHR—about 65% of their height—had nearly three times the risk of heart failure compared to those in the lower groups.
Dr. John Molvin, a co-author of the study from Lund University and Malmö University Hospital, emphasized that most of the people in the study had a WtHR well above 0.5, the threshold for increased health risks.
He suggested that aiming for a waist size less than half of one’s height could be an effective health goal. According to him, WtHR might be a better measure than BMI for identifying people at risk of heart failure, especially those who might benefit from weight-loss strategies and medical support.
The researchers believe that their findings point to WtHR as a simple, practical tool for doctors and patients. It does not require complicated calculations—just measure your waist and height and compare the two.
If your waist is more than half of your height, it may be time to consider lifestyle changes. The team plans to extend their research to see if WtHR can also predict other heart and metabolic problems in larger groups of people.
This study adds to growing evidence that where fat is stored matters as much as how much fat there is. By focusing on WtHR instead of BMI, doctors might better identify those at risk for heart failure and take preventive steps sooner. The simplicity of measuring waist and height makes it an easy, accessible tool for people to monitor their health and make necessary changes.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and Vitamin K2 could help reduce heart disease risk.
For more information about heart health, please see recent studies about how to remove plaques that cause heart attacks, and results showing a new way to prevent heart attacks, strokes.
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