The new test could fix the issues with BMI and only takes a few seconds
Obesity is well-known risk factor for heart problems and heart failure. However, the current measurement used to determine obesity and heart failure risk, the Body Mass Index or BMI, also has well-known limitations.
Scientists have now discovered an alternative test that can be easily conducted at home using just a measuring tape. And it could provide a more accurate prediction of your risk of heart failure. This method utilises the waist-to-height ratio.
Simply measure your waist and your height and then compare the two figures. The researchers behind the new study, presented at the Heart Failure 2025 conference in Serbia this week, said the ideal waist measurement should be less than half of your height measurement.
For instance, if you are 5ft 10ins (equivalent to 70ins), your waist measurement should be under 35ins to reduce your risk of heart failure. A measurement above 35ins could indicate a higher risk and suggest that you may need assistance in preventing heart failure.
Worryingly, the majority of people in the study were above this recommended mark. It is crucial to accurately measure your waist when conducting this test.
According to NHS guidelines, you should start by locating your lowest rib and the highest part of your hip bone on your side. Aim for the midpoint between these two points, which will typically align with your belly button.
This is where the measuring tape should wrap around. Breathe out naturally and relax your stomach muscles when taking your measurement.
Study presenter Dr Amra Jujic, from Lund University in Malmö, Sweden, has shed light on the limitations of Body Mass Index (BMI) as a measure of obesity: “BMI is the most common measure of obesity, but it is influenced by factors such as sex and ethnicity, and does not take into account the distribution of body fat. Waist-to-height ratio is considered a more robust measure of central adiposity, the harmful deposition of fat around visceral organs.”
She further elaborated on the relationship between waist-to-height ratio and heart failure: “In addition, whereas BMI is associated with paradoxically good heart failure outcomes with high BMI, this is not seen with waist-to-height ratio. We conducted this analysis to investigate the relationship between waist-to-height ratio and the development of heart failure.”
The NHS provides a handy calculator for this test that offers precise figures and guidance on your waist size. It advises: “Slowly working towards a lower waist size can help prevent conditions like type 2 diabetes, heart disease and high blood pressure.”
The research involved close to 2,000 individuals from the Malmö Preventive Project, with a third having normal blood sugar levels, another third with impaired levels, and the remaining third suffering from diabetes.
The findings were stark, revealing that participants with the highest waist-to-height ratios had “a significantly higher risk of heart failure” when compared to others in the study. Alarmingly, the average ratio across all participants was still above the recommended threshold.
Dr John Molvin, from Lund University and Malmö University Hospital, Sweden, a co-author of the study, observed: “The median waist-to-height ratio in our analysis was considerably higher than 0.5, the cut-off for increased cardiometabolic risk. Having a waist measurement that is less than half your height is ideal.
“We discovered that the waist-to-height ratio was a significant predictor of incident heart failure and our findings suggest that this ratio may be a more effective metric than BMI for identifying patients with heart failure who could benefit from obesity therapies. Our next step is to explore whether the waist-to-height ratio predicts incident heart failure and other cardiometabolic disorders in a larger cohort.”