Research presented at the American Heart Association's EPI|Lifestyle Scientific Sessions 2026 suggests that measurements of excess weight around the waist may increase heart failure risk primarily due to inflammation. The study found that higher waist circumference and waist-to-height ratio were more strongly linked to heart failure risk than overall body weight or body mass index.
During a median follow-up period of 6.9 years, 112 adults developed heart failure among 1,998 African American participants in the Jackson Heart Study. Elevated measurements of excess weight around the waist were associated with increased heart failure risk, while high BMI was not. Participants with higher inflammation levels, as measured by blood tests for high-sensitivity C-reactive protein, were more likely to experience heart failure over the follow-up period.
"This research helps us understand why some people develop heart failure despite having a body weight that seems healthy," said Szu-Han Chen, lead author of the study and a medical student at National Yang Ming Chiao Tung University in Taiwan. The study found that inflammation accounted for about one-quarter to one-third of the link between measures of fat stored around the waist and heart failure risk.
According to a 2025 scientific statement from the American Heart Association focused on risk-based primary prevention of heart failure, systemic inflammation is a common risk factor for heart disease because it can disrupt the immune system, damage blood vessels and lead to the build up of scar tissue in the heart. The Association has also highlighted evidence that higher levels of inflammation in the body are linked to an increased risk of heart disease, even in adults with normal cholesterol levels.
"This study highlights the importance of integrating measures of central adiposity such as waist circumference into routine preventive care," said Sadiya S. Khan, M.D., M.Sc., FAHA, volunteer chair of the American Heart Association's 2025 Scientific Statement: Risk-Based Primary Prevention of Heart Failure. "Understanding upstream drivers of heart failure risk including central adiposity is key to recognizing and modifying risk."
The American Heart Association recently launched the Systemic Inflammation Data Challenge to encourage collaboration and deepen understanding of how inflammation contributes to heart disease and related conditions including heart failure. This initiative builds on growing evidence about inflammation's role in cardiovascular health.
Researchers noted they did not have access to participants' heart failure subtypes, so the findings apply to all types of heart failure together. Future research should examine how visceral fat and inflammation relate to different types of heart failure and whether reducing inflammation can help prevent or reduce heart failure risk. The study was conducted under the guidance of Professor Hao-Min Cheng at Taipei Veterans General Hospital and National Yang Ming Chiao Tung University.
The findings point to opportunities to identify people at higher risk of heart failure using waist measurements rather than relying only on BMI. 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. The mediating role of inflammation in the association between central obesity and heart failure suggests that reducing inflammation levels may be a potential treatment strategy to reduce heart failure risk in these individuals.
