Study finds a better tool than BMI to predict heart attacks early

For decades, Body Mass Index has been the standard measure for assessing weight-related health risks. But new research suggests it may be overlooking a significant number of people who are quietly developing heart disease.

A study led by physician-scientists at UPMC and the University of Pittsburgh, published in The Lancet Regional Health—Americas, found that a person’s waist-to-height ratio is a stronger predictor of future cardiovascular problems than BMI. The researchers analysed data from 2,721 adults in the long-running Brazilian Longitudinal Study of Adult Health and tracked them for more than five years.Once classic risk factors such as age, smoking, cholesterol and blood pressure were accounted for, BMI lost much of its predictive value.

In contrast, waist-to-height ratio — which highlights how much fat is carried around the abdomen — continued to signal increased risk, even among people who technically fell below the obesity threshold. The study indicates that many individuals with a “normal” BMI could still carry harmful visceral fat that quietly contributes to coronary artery calcification and, over time, heart attack risk.

Why BMI may miss the warning signs of heart diseases

BMI calculates weight in relation to height, but it cannot differentiate between muscle and fat, nor does it identify where fat is stored.

Visceral fat, which accumulates around internal organs, is particularly dangerous. It promotes inflammation and arterial damage, raising the likelihood of heart disease even when surface weight appears normal.Waist-to-height ratio (WHtR) is measured by dividing waist circumference by height. The recommended benchmark is 0.5 — meaning your waist should ideally be less than half your height. This measurement is more sensitive to central obesity, making it better aligned with cardiovascular risk.

Why this matters for early prevention

Adopting WHtR in routine health screenings could help identify at-risk individuals sooner, prompting earlier lifestyle interventions such as improved diet, increased physical activity and closer monitoring of blood pressure and glucose levels. Because it requires only a tape measure, it is practical in both clinics and home settings.Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making any changes to your health routine or treatment.