Study Reveals Waist-to-Height Ratio as Key Indicator for Heart Failure Risk

Recent research presented at the Heart Failure 2025 conference highlights the waist-to-height ratio (WtHR) as a significant predictor of heart failure (HF) incidence. This finding comes in response to the growing concern over obesity, which is prevalent among heart failure patients and is associated with an increased risk of developing heart conditions.

Dr. Amra Jujic from Lund University in Malmö, Sweden, emphasized that while body mass index (BMI) is a widely used metric for assessing obesity, it has limitations. BMI can be influenced by various factors, including sex and ethnicity, and it does not adequately account for the distribution of body fat. In contrast, WtHR is viewed as a more reliable measure of central obesity, specifically the harmful accumulation of fat around internal organs.

During the study, researchers analyzed a cohort of 1,792 participants drawn from the Malmö Preventive Project. These individuals, aged between 45 and 73 at the outset, were selected to represent a broad spectrum of glucose tolerance, with one-third having normal blood glucose levels, another third exhibiting impaired fasting glucose, and the final third diagnosed with diabetes. The participants were monitored over an average follow-up period of 12.6 years to track the occurrence of heart failure.

The average age of participants in the study was 67 years, with women constituting 29% of the population. The median WtHR recorded was 0.57, within an interquartile range of 0.52 to 0.61. The findings revealed that a higher WtHR correlates with a markedly increased risk of developing heart failure, with a hazard ratio of 1.34 for each standard deviation increase in WtHR (95% confidence interval of 1.12-1.61; p=0.001), independent of other influencing factors.

When participants were categorized into quartiles based on their WtHR, those in the highest quartile (median WtHR of 0.65) faced a significantly elevated risk of heart failure compared to individuals in the lower three quartiles, with a hazard ratio of 2.71 (95% CI, 1.64-4.48; p<0.001).

Dr. John Molvin, a co-author of the study from Lund University and Malmö University Hospital, highlighted that the median WtHR observed in the study exceeded the 0.5 threshold, which is often considered the cut-off for increased cardiometabolic risk. He stressed that having a waist circumference less than half of one's height is ideal for reducing heart disease risks.

Dr. Molvin concluded that the study's results indicate WtHR is a significant predictor of heart failure incidence. This suggests that WtHR could serve as a more effective measurement than BMI in identifying patients at risk for heart failure who may benefit from obesity-targeted therapies. Future research is planned to investigate whether WtHR can also predict other cardiometabolic disorders in a larger population.

For further details, refer to the study on waist-to-height ratio as a predictor of heart failure.