A study published in JACC by the American College of Cardiology found that waist circumference (WC) and waist-to-hip ratio (WHR) better predict cardiovascular disease risk than BMI alone. The research, analyzing over 260,000 people over 20 years, revealed that individuals with normal BMI but high central adiposity had 15%-50% greater risk for nine cardiovascular outcomes including heart attack and stroke.

Senior author Michael J. Blaha, MD, MPH, noted that WC and WHR reclassify risk beyond traditional BMI thresholds, with 5% of normal-weight individuals and 39% of overweight individuals showing high WC.

Lead author Zeina A. Dardari, Ph.D., emphasized the importance of considering central adiposity across the entire BMI spectrum, stating that where fat is distributed matters significantly for risk assessment.

Harlan M. Krumholz, MD, SM, Editor-in-Chief of JACC, stated it is time to abandon sole focus on BMI, as these simple measures should be part of routine cardiovascular risk assessment.