New research suggests that carrying excess weight around the midsection may be a stronger predictor of heart failure than overall body weight, even in individuals with a healthy body mass index (BMI). The findings, presented at the American Heart Association’s EPI|Lifestyle Scientific Sessions 2026, highlight the importance of considering fat distribution when assessing cardiovascular risk. Understanding these risk factors is crucial for preventative care and improving patient outcomes.
The study, led by Szu-Han Chen, a medical student at National Yang Ming Chiao Tung University in Taiwan, followed nearly 2,000 adults for seven years to investigate how the location of body fat impacts heart health. Researchers aimed to determine if visceral fat – the fat stored around the abdominal organs – played a more significant role in cardiac issues than previously understood.
The research team discovered that systemic inflammation linked to abdominal fat accounted for approximately one-quarter to one-third of the connection between excess weight around the waist and heart failure. This association remained significant regardless of an individual’s overall weight, suggesting that where fat is stored is a critical factor.
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Limitations of Body Mass Index in Cardiac Evaluation
Elevated BMI alone did not prove to be as reliable an indicator. Photo:Istock
For decades, the body mass index (BMI) has been a standard measurement for assessing general health. However, this study indicates that BMI may not fully capture cardiovascular risks. The findings address a clinical question of why individuals with a seemingly normal weight can still develop serious heart conditions.
According to the data, relying solely on BMI proved to be less reliable than measuring waist circumference or the ratio between height and abdominal diameter.
The Role of Visceral Fat as an Inflammatory Agent
This process prevents the heart from pumping blood effectively. Photo:Istock
Unlike subcutaneous fat, which lies beneath the skin, visceral fat surrounding internal organs is metabolically active. This activity releases substances that disrupt the immune system and damage blood vessels, contributing to scarring of the heart muscle. This process impairs the heart’s ability to pump blood efficiently.
“This research helps us understand why some people develop heart failure despite having a body weight that seems healthy,” said Szu-Han Chen, the lead researcher. Chen emphasized that monitoring waist size and markers of inflammation in the blood could help specialists identify at-risk patients early, before the onset of clinical symptoms.
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Implications for Prevention and Primary Care
The current recommendation focuses on monitoring abdominal diameter through diet. Photo:Istock
The scientific community, including Dr. Sadiya S. Khan of Northwestern University, stresses the need to incorporate these measurements into routine primary care. Recognizing central obesity as a key factor allows for the modification of preventative strategies.
While further research is needed to determine if these findings apply equally to all subtypes of heart failure, the current recommendation centers on monitoring abdominal diameter through diet and exercise to reduce systemic inflammation and protect heart function.
*This content was written with the assistance of artificial intelligence, based on publicly available information disclosed to media outlets. It was reviewed by a journalist and an editor.
JAIDER FELIPE VARGAS MORALES
REDACCIÓN ALCANCE DIGITAL
