New research shows that heart attack survivors who have extra weight around their waist are at a greater risk of another heart attack. This is another reason why measuring the waist may actually be more important than stepping on the scale. 

Excess weight around the waist has already been known to increase the odds of having a first heart attack. However, these new findings published in the European Journal of Preventive Cardiology show, for the first time, the link between belly fat and the risk of a subsequent heart attack or stroke. The link between waist circumference and the heart was found to be particularly strong in men. 

According to Dr. Hanieh Mohammadi of the Karolinska Institute in Stockholm, it is important to maintain a healthy waist circumference if one wants to prevent future heart attacks and stroke. This is true even if the patient is taking preventive medicine and/or if their blood tests are all clear. 

The study was conducted with 22,000 patients after their first attack. The researchers looked at the link between waist circumference and events caused by clogged arteries like fatal and non-fatal heart attacks and stroke. Study participants were followed up for four years. 7.3% of men and 7.9% of women experienced a heart attack or stroke. 78% of men and 90% of women had abdominal obesity (defined as a waist circumference of 94 cm/37.6 inches or above for men, and 80 cm/32 inches or above for women). 

Findings showed that abdominal fat was associated with heart attacks and stroke independent of other risk factors, such as smoking, diabetes, hypertension, BMI etc. These findings suggest that waist circumference is a more important marker than overall obesity. 

The relationship between the heart and the waist was found to be much stronger in men than women. In women, mid-range waist measurement rather than the narrowest, was found to be least risk - the mid-range being more than 80 cm wide, traditionally recognised as at risk for abdominal obesity. This difference between men and women may exist because men have more visceral fat that goes inside their bodies and wraps around their vital organs. In women, it is believed that most portion of the abdominal fat is constituted by subcutaneous fat which may be relatively harmless. 

Abdominal fat is thus an important risk factor for subsequent heart attack or stroke. The fat in this area can turn into cholesterol that can start collecting and hardening the arteries, leading to a heart attack or stroke. The World Health Organization (WHO) states that the risk of cardiovascular disease is higher in those with a waist measurement of over 94 cm in men and over 80 cm in women. The risk increases more in men with a waist wider than 102 cm and women with a waist wider than 88 cm. 

The best way to control abdominal fat is through a healthy diet and regular exercise. A moderate cardio workout such as walking for at least 30 minutes a day can help control abdominal fat. Strength training can also help. 

Image Credit: iStock


Matos D, Ferreora AM (2020) The heart and the waist: Relationship between abdominal fat and recurrent events after myocardial infarction. European Journal of Preventive Cardiology.

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