The shape of our bodies and where we carry weight, appears to be a more significant indicator of heart health than previously understood. New research presented at the American Heart Association’s EPI|Lifestyle Scientific Sessions 2026 suggests that excess fat around the waist – often referred to as visceral fat or central obesity – is a stronger predictor of heart failure risk than body mass index (BMI). This finding challenges the long-held reliance on BMI as the primary measure of cardiovascular risk and highlights the importance of considering body fat distribution in preventative care. The research, unveiled in Boston from March 17-20, underscores a growing understanding of the complex relationship between inflammation, obesity, and heart disease.
For decades, BMI – a calculation based on height and weight – has been a standard tool for assessing weight status and associated health risks. Yet, BMI doesn’t differentiate between muscle mass and fat, nor does it account for where fat is stored in the body. This new study, conducted by researchers at National Yang Ming Chiao Tung University in Taiwan, demonstrates that visceral fat, the fat stored deep within the abdomen surrounding vital organs, is particularly dangerous. It’s not simply about *how much* fat a person carries, but *where* it’s located. This research builds on a growing body of evidence suggesting that central adiposity plays a critical role in the development of heart failure, even in individuals who appear to be within a healthy weight range according to BMI.
The study, which analyzed data from nearly 2,000 African American adults participating in the Jackson Heart Study, found that individuals with higher levels of visceral fat were significantly more likely to develop heart failure over a nearly seven-year follow-up period. Crucially, this increased risk was observed even after accounting for BMI. Researchers also discovered that both waist circumference and the waist-to-height ratio were linked to a greater risk of heart failure. This suggests that a simple measurement – a tape around the waist – could provide valuable insights into an individual’s cardiovascular health, potentially identifying those at risk before symptoms even appear. The Jackson Heart Study, initiated in 2000, is the largest study of cardiovascular disease in African Americans and aims to understand the genetic, environmental, and behavioral factors that contribute to heart disease in this population. More information about the Jackson Heart Study can be found on their official website.
The Role of Inflammation: A Key Link
A central finding of the research is the role of inflammation in mediating the link between abdominal fat and heart failure. Systemic inflammation, a state of chronic low-grade inflammation throughout the body, is increasingly recognized as a major contributor to a wide range of chronic diseases, including cardiovascular disease. The American Heart Association highlighted this connection in a 2025 scientific statement on risk-based primary prevention of heart failure, emphasizing that inflammation can disrupt immune function, damage blood vessels, and promote the buildup of scar tissue in the heart. The American Heart Association’s statement on inflammation and heart failure provides further detail on this critical connection. The study found that inflammation accounted for approximately one-quarter to one-third of the association between abdominal fat and heart failure risk, suggesting that reducing inflammation levels could be a potential therapeutic strategy.
Study Details and Key Findings
The analysis encompassed health data from 1,998 African American adults residing in urban and rural areas of Jackson, Mississippi, who were enrolled in the Jackson Heart Study between 2000 and 2004. None of the participants had heart failure at the time of enrollment. Over a median follow-up period of 6.9 years, through December 31, 2016, 112 participants developed heart failure. Researchers assessed body fat using multiple measures, including weight, BMI, waist circumference, and waist-to-height ratio. Blood samples were analyzed for high-sensitivity C-reactive protein (hs-CRP), a widely used biomarker of inflammation.
The key findings of the study were compelling: higher levels of excess fat around the waist were associated with an increased risk of heart failure, while higher BMI was not. Both waist circumference and waist-to-height ratio were independently linked to greater risk. Participants with higher levels of inflammation, as measured by hs-CRP, were more likely to develop heart failure over the nearly seven-year study period. These findings reinforce the idea that visceral fat isn’t simply a marker of overall obesity, but an active contributor to cardiovascular disease risk.
Implications for Prevention and Screening
Sadiya S. Khan, M.D., M.Sc., FAHA, volunteer chair of the American Heart Association’s 2025 Scientific Statement on Risk-Based Primary Prevention of Heart Failure, emphasized the importance of integrating measures of central adiposity, such as waist circumference, into routine preventive care. “Understanding upstream drivers of heart failure risk including central adiposity is key to recognizing and modifying risk,” she stated. Dr. Khan, a Magerstadt Professor of Cardiovascular Epidemiology and an associate professor of cardiology and preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago, also noted that the study builds upon prior research highlighting the importance of excess or dysfunctional adiposity in heart failure development, which informed the inclusion of BMI in the PREVENT-HF risk equations. Dr. Khan’s profile at Northwestern University provides additional information about her research and expertise.
The study’s lead author, Szu-Han Chen, a medical student at National Yang Ming Chiao Tung University in Taiwan, explained that the research helps to understand why some individuals develop heart failure despite maintaining a seemingly healthy body weight. “By monitoring waist size and inflammation, clinicians may be able to identify people with higher risk earlier and focus on prevention strategies that could reduce the chance of heart failure before symptoms begin,” Chen said. This proactive approach could involve lifestyle interventions such as dietary changes, increased physical activity, and strategies to reduce inflammation.
Looking Ahead: Future Research and Clinical Implications
The researchers acknowledge that their study has limitations. They did not have detailed data on different subtypes of heart failure, meaning the findings apply to heart failure overall. Future studies are needed to explore how visceral fat and inflammation specifically affect various types of heart failure and to determine whether reducing inflammation could directly lower risk. Further investigation is also warranted to assess whether central adiposity offers greater predictive utility than BMI alone in identifying individuals at risk of heart failure.
This research underscores the need for a more nuanced approach to assessing cardiovascular risk. While BMI remains a useful tool, it should not be the sole determinant of health status. Measuring waist circumference and considering inflammatory markers may provide a more comprehensive and accurate picture of an individual’s risk for heart failure. The findings also highlight the importance of lifestyle interventions aimed at reducing abdominal fat and inflammation as a key component of heart failure prevention. As we learn more about the complex interplay between body composition, inflammation, and cardiovascular health, You can develop more targeted and effective strategies to protect against this debilitating condition.
The American Heart Association continues to fund research into the causes and prevention of heart failure. The next major conference highlighting advancements in cardiovascular health will be the American Heart Association’s Scientific Sessions in November 2026. Stay informed about the latest research and guidelines by visiting the American Heart Association’s website.
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