This common body shape could quietly raise heart failure risk
· The South African
Two people can have the same weight and the same body mass index, yet their long-term heart health may differ significantly.
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Researchers say the difference may come down to how the body stores fat and what that action does inside the body over time.
New findings suggest that this previously overlooked factor may play a more significant role in heart failure risk than previously thought.
Belly fat linked to heart failure risk
Research presented at the American Heart Association’s 2026 Scientific Sessions suggests that fat stored around the waist may be more strongly linked to heart failure than overall body weight.
The study found that waist circumference and waist-to-height ratio were better indicators of heart failure risk than body mass index (BMI) alone.
The health industry widely uses BMI to assess weight-related health risks, but it does not distinguish between muscle and fat, or show where the body stores fat.
This may explain why some people who fall within a “healthy” BMI range can still face a higher risk of cardiovascular disease.
Lead author Szu-Han Chen said the findings may help explain why heart failure sometimes develops in people whose weight appears normal.
“This research helps us understand why some people develop heart failure despite having a body weight that seems healthy,” Chen said.
Why inflammation matters
The study also highlights the role of inflammation, which researchers say may account for up to a third of the connection between belly fat and heart failure.
Inflammation is already seen as a key driver in cardiovascular disease. Over time, chronic inflammation can damage blood vessels, disrupt normal immune responses, and contribute to scarring in heart tissue.
Participants with higher levels of inflammatory markers in their blood were significantly more likely to develop heart failure during the study.
Researchers believe this is partly because visceral fat is metabolically active, releasing inflammatory substances into the body.
Waist size vs BMI in link between belly fat and heart failure risk
The findings add to growing concerns among health experts that BMI alone may not tell the full story about heart health. In fact, some researchers say an overlooked body measurement may reveal hidden heart disease risk even in people whose weight appears normal.
Someone can fall within a “healthy” weight range while still carrying excess fat around the abdomen, meaning belly fat may increase their heart failure risk.
Unlike fat stored under the skin elsewhere in the body, visceral fat accumulates around internal organs, making it particularly harmful over time.
Some experts are increasingly recommending including waist measurements alongside BMI in routine health checks to better assess cardiovascular risk.
The study link between belly fat and heart failure risk
The research analysed nearly 2 000 adults over an average follow-up period of almost seven years. During that time, 112 participants developed heart failure. Higher waist circumference was linked to a greater risk, and inflammation explained part of the connection between abdominal fat and heart disease.
However, researchers caution that the findings are preliminary. The study has not yet been published in a peer-reviewed journal.
In a world where one in five heart attack patients is under the age of 40, it may be time to start taking our health more seriously and ensure our belly fat does not increase our risk for heart failure.