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'BMI' a Bust for Predicting Heart Risk

Body Mass Index May Not Be Useful in Predicting Risk From Heart Disease

Fat vs. Fit

There is intriguing evidence that two alternative tests -- measuring waist circumference or waist-to-hip ratio -- may be better ways to distinguish between the fit and the fat.

Although BMI has been used in most studies, Lopez-Jimenez says the few studies that have calculated obesity using waist circumference or waist-to-hip ratio suggest that these measures are more predictive of poor health outcomes.

American Heart Association former president Robert Eckel, MD, tells WebMD that he considers waist circumference measurement a routine part of a patient exam.

"I still calculate BMI," he says. "But waist circumference may be a better indicator of cardiovascular disease risk that goes beyond BMI."

A study published late last year found waist-to-hip ratio to be a much better predictor of heart attack risk than BMI in many different ethnic groups.

Researcher Salim Yusuf, MD, and colleagues from the Population Health Research Institute at Ontario’s McMaster University concluded that BMI is a weak predictor of heart attack risk.

But Eckel says measuring BMI may be more beneficial than the studies suggest if patients who are considered overweight or obese end up being treated more aggressively with heart-protecting therapies.

"Someone with a BMI of 30 or above is likely to have other risk factors," he says. "It may be that the better outcomes among heavier people in this study could be explained by more aggressive treatment to control hypertension, LDL cholesterol, triglycerides [blood fats] and glucose [blood sugar]."

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