Waist-to-Height Ratio as a Key Predictor of Heart Failure Risk

A recent study presented at Heart Failure 2025 highlights the significance of the waist-to-height ratio (WtHR) in predicting the incidence of heart failure (HF). The research emphasizes that while obesity is a known risk factor for HF, traditional measures like body mass index (BMI) have limitations, as they are influenced by factors such as sex and ethnicity and do not account for fat distribution. In contrast, WtHR provides a more accurate assessment of central adiposity, which relates to harmful fat deposits around visceral organs.

The study analyzed 1,792 participants aged 45 to 73 from the Malmö Preventive Project, including individuals with normal blood glucose, impaired fasting glucose, and diabetes. Over a median follow-up of 12.6 years, 132 participants developed HF. Results showed that higher WtHR was significantly associated with increased HF risk; specifically, each standard deviation increase in WtHR raised the hazard ratio by 1.34. Participants in the highest WtHR quartile (median 0.65) had a 2.71 times greater risk of developing HF compared to those in lower quartiles.

Dr. Amra Jujic from Lund University explained that a WtHR below 0.5 is considered ideal, as waist measurements less than half of height are linked with reduced cardiometabolic risk. The findings suggest that WtHR could serve as a more effective metric than BMI for identifying patients at risk of HF who might benefit from targeted obesity therapies.

The study underscores the importance of using body composition metrics that reflect fat distribution rather than overall weight alone. Future research aims to explore WtHR's predictive power for other cardiometabolic disorders across larger populations.