A new study presented at Heart Failure 2025, a scientific congress of the European Society of Cardiology, has found that the waist-to-height ratio (WtHR) is a strong predictor of future heart failure—potentially even more reliable than body mass index (BMI).
Heart failure (HF) remains one of the most serious health complications worldwide, and obesity is a major risk factor.
However, BMI, the most commonly used measure to define obesity, has significant limitations.
It doesn’t account for how fat is distributed across the body and is influenced by factors such as sex and ethnicity.
More importantly, while a higher BMI often correlates with a greater risk of heart disease, it has also shown paradoxically better outcomes in some HF patients—a phenomenon known as the “obesity paradox.”
The researchers from Lund University in Sweden—led by Dr. Amra Jujic and co-author Dr. John Molvin—sought to address these shortcomings by exploring the value of the waist-to-height ratio, which is believed to better reflect central obesity, or fat concentrated around internal organs. This kind of fat, known as visceral fat, is more harmful than fat located elsewhere in the body.
The study used data from the Malmö Preventive Project, involving 1,792 adults between the ages of 45 and 73.
The researchers intentionally selected a sample with a mix of glucose metabolism statuses: about one-third had normal blood sugar, one-third had impaired fasting glucose, and one-third had diabetes. These individuals were followed over a median period of 12.6 years to track the development of heart failure.
Over the course of the study, 132 participants experienced heart failure. Researchers found that a higher waist-to-height ratio was clearly linked to an increased risk of heart failure. For each standard deviation increase in WtHR, the risk of developing HF rose by 34%—even after accounting for other factors.
In a more detailed breakdown, individuals in the top quartile of WtHR (with a median of 0.65) were nearly three times more likely to develop HF compared to those in the lower three quartiles.
The average WtHR in the study was 0.57—already above the commonly accepted threshold of 0.5, which marks an increased risk of heart and metabolic problems. According to Dr. Molvin, this suggests that many adults may already be in a danger zone without realizing it. “Having a waist measurement that is less than half your height is ideal,” he noted.
The results support the idea that WtHR might be a more effective tool than BMI for identifying individuals at high risk of heart failure. Unlike BMI, WtHR directly measures central fat, which plays a more harmful role in cardiovascular disease.
The researchers believe that this simple and inexpensive measurement could help improve how obesity-related risks are evaluated in clinical settings.
The study team now plans to expand their research to explore whether WtHR can also predict other conditions like diabetes, stroke, or heart attacks in larger and more diverse populations.
In short, this study suggests that looking at the proportion between your waist and height may be a better way to assess your heart health risk than relying solely on BMI. Keeping your waist circumference below half your height might not just be a rule of thumb—it could be a lifesaving guideline.
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 health, please see recent studies that olive oil may help you live longer, and Vitamin C linked to lower risk of heart failure.
Copyright © 2025 Knowridge Science Report. All rights reserved.
