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Home 2. Cardiology 1. Home 2. Overweight & Obesity * * * --------------------------------------------------------------------- November 3, 2025 The GIST Waist-to-height ratio outperforms BMI in predicting heart disease risk by University of Pittsburgh Schools of the Health Sciences edited by Lisa Lock, reviewed by Robert Egan [llock] Lisa Lock scientific editor Meet our editorial team Behind our editorial process [Robert] Robert Egan associate editor Meet our editorial team Behind our editorial process Editors' notes This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility: fact-checked trusted source proofread weight scale and tape Credit: Pixabay/CC0 Public Domain The ratio of a person's waist measurement compared to their height is more reliable than body mass index (BMI) at predicting heart disease risk, according to new research from UPMC and University of Pittsburgh physician-scientists. This finding, published in The Lancet Regional Health--Americas, could reshape how clinicians and the public assess cardiovascular risk, especially for people who don't meet the classic definition of obesity. The team analyzed data from 2,721 adults who had participated in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The individuals had no cardiovascular disease at baseline and were followed for more than five years. "Higher BMI, waist circumference and waist-to-height ratio at baseline were all associated with higher risk of developing future cardiovascular disease--until we adjusted for other classic risk factors, such as age, sex, smoking, exercise, diabetes, hypertension and cholesterol," said lead author Thiago Bosco Mendes, M.D., instructor of medicine at Pitt and obesity medicine fellow at UPMC. "When we did that, only waist-to-height ratio held as a predictor." Much of that predictive power is concentrated among individuals with a BMI under 30, which is below the classic threshold for obesity, who may not realize they are at risk for cardiovascular disease. BMI doesn't account for fat distribution or distinguish between harmful, visceral fat and protective, subcutaneous fat. By contrast, waist-to-height ratio (WHtR), calculated by dividing waist circumference by height, directly reflects central obesity, which is more closely linked to heart disease. That means that people with a BMI lower than 30, but a WHtR over 0.5, may be at higher risk of future coronary artery calcification, a key marker of cardiovascular disease, even in the absence of other risk factors. "Using waist-to-height ratio as a cardiovascular screening tool could lead to earlier identification and intervention for at-risk patients who might otherwise be missed," said senior author Marcio Bittencourt, M.D., Ph.D., MPH, associate professor of medicine at Pitt and cardiologist at UPMC. "It's a simple and powerful way to spot heart disease risk early, even if a patient's weight, cholesterol and blood pressure all seem normal." More information: Thiago Bosco Mendes et al, Waist-to-height ratio and coronary artery calcium incidence: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), The Lancet Regional Health - Americas (2025). DOI: 10.1016/j.lana.2025.101281 Provided by University of Pittsburgh Schools of the Health Sciences Citation: Waist-to-height ratio outperforms BMI in predicting heart disease risk (2025, November 3) retrieved 3 November 2025 from https: //medicalxpress.com/news/ 2025-11-waist-height-ratio-outperforms-bmi.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. 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WHtR better reflects central obesity, which is closely linked to heart disease, and can identify at-risk individuals who may be missed by traditional measures. A WHtR over 0.5 indicates increased risk, even when other risk factors are absent. This summary was automatically generated using LLM. Full disclaimer Let us know if there is a problem with our content Use this form if you have come across a typo, inaccuracy or would like to send an edit request for the content on this page. For general inquiries, please use our contact form. For general feedback, use the public comments section below (please adhere to guidelines). Please select the most appropriate category to facilitate processing of your request [-- please select one -- ] [ ] [ ] [ ] [ ] [ ] Your message to the editors [ ] Your email (optional, only if you'd like a response) [ ] Send Feedback Thank you for taking time to provide your feedback to the editors. Your feedback is important to us. 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