Belly Fat Trumps BMI as Heart Failure Risk Predictor, Study Finds

Excess belly fat is a stronger predictor of heart failure risk than overall body weight or BMI, according to new research presented at the AHA’s EPI/Lifestyle Scientific Sessions 2026 in Boston from March 17–20.

The study, led by Szu-Han Chen, a medical student at National Yang Ming Chiao Tung University in Taiwan, found that systemic inflammation plays a key role in the relationship between abdominal fat and heart disease. Researchers estimate that inflammation explains one-quarter to one-third of this association.

“This research helps us understand why some people develop heart failure despite having a body weight that seems healthy,” Chen said in a statement. “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.”

Why Belly Fat Matters More Than BMI

The findings challenge the traditional reliance on BMI as a sole indicator of cardiovascular risk. Instead, the study emphasizes the importance of central obesity—fat stored around the abdomen—as a more accurate predictor of heart failure.

“This study reinforces an important concept in cardiology: where fat is stored in the body may matter more than total body weight alone,” said Dr. Kevin Shah, a cardiologist and program director of Heart Failure Outreach at MemorialCare Heart Vascular Institute in California. “One practical takeaway from this study is that clinicians and patients may want to pay more attention to waist circumference and central obesity, since those measures may reveal cardiovascular risk even in individuals whose BMI appears normal.”

Inflammation: The Hidden Link Between Belly Fat and Heart Disease

This research aligns with a 2025 scientific statement from the American Heart Association (AHA), which warned that inflammation can disrupt the immune system, damage blood vessels, and lead to scar tissue buildup in the heart. The AHA has also launched the Systematic Inflammation Data Challenge to explore how inflammation contributes to heart disease.

“This is a strong study that aligns with existing research indicating that central or truncal obesity poses a greater risk for cardiovascular disease than peripheral fat,” said Dr. Mir Ali, a bariatric surgeon and medical director of the MemorialCare Surgical Weight Loss Center in California.

Key Takeaways for Heart Health

• Excess belly fat is a stronger predictor of heart failure risk than BMI.
• Systemic inflammation explains a significant portion of the link between abdominal fat and heart disease.
• Monitoring waist circumference and inflammation may help identify at-risk individuals earlier.
• Central obesity poses greater cardiovascular risks than peripheral fat distribution.