Cardiovascular Health 2025

#1143

The ratio of a person’s waist measurement compared to their height is more reliable than body mass index (BMI) at predicting heart disease risk, according to new research from UPMC and University of Pittsburgh physician-scientists.

This finding, published Oct. 31, 2025, in The Lancet Regional Health—Americas, could reshape how clinicians and the public assess cardiovascular risk, especially for people who don’t meet the classic definition of obesity.

The team analyzed data from 2,721 adults who had participated in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The individuals had no cardiovascular disease at baseline and were followed for more than five years.

“Higher BMI, waist circumference and waist-to-height ratio at baseline were all associated with higher risk of developing future cardiovascular disease—until we adjusted for other classic risk factors, such as age, sex, smoking, exercise, diabetes, hypertension and cholesterol,” said lead author Thiago Bosco Mendes, clinical instructor of medicine at Pitt and obesity medicine fellow at UPMC. “When we did that, only waist-to-height ratio held as a predictor.”

Much of that predictive power is concentrated among individuals with a BMI under 30, which is below the classic threshold for obesity, who may not realize they are at risk for cardiovascular disease.

BMI doesn’t account for fat distribution or distinguish between harmful, visceral fat and protective, subcutaneous fat. By contrast, waist-to-height ratio (WHtR), calculated by dividing waist circumference by height, directly reflects central obesity, which is more closely linked to heart disease. That means that people with a BMI lower than 30, but a WHtR over 0.5, may be at higher risk of future coronary artery calcification, a key marker of cardiovascular disease, even in the absence of other risk factors.

The research paper:

https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(25)00292-3/fulltext

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#1144

What you’d want to do is collaborate with a researcher who can get permission from their university ethics committee to include your test results etc. Case studies are often reported about people doing “off-label” things.

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#1147

This year we’ve gotten signals that a major shift is ongoing, from fixation on obstructive coronary artery disease (simply put “blockages”) to the focus on non-obstructive arterial disease (simply put “atheroma”), as visualized non-invasively to be high-risk, so-called vulnerable atherosclerotic plaque, and/or exhibiting inflammation (Figure below). This Ground Truths edition will take you through the evolution of the thinking and capabilities, with new non-invasive A.I. imaging, and new drugs, that may ultimately lead to a major reduction in heart attacks.

Although statins have helped reduce the risk of heart attack, we still have over 800,000 each year in the United States, which is similar to the data spanning 2012 to 2022, and heart disease remains the number 1 killer despite a marked reduction in death rates over the past 2 decades. Even with 1 in 4 Americans taking statins now, it’s clear we’re far away from their disappearance. One prescient note in the Science editorial was “The challenge is to develop noninvasive screening methods to detect coronary atherosclerosis in its earliest stages.”

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#1148

Screenshot 2025-11-16 at 1.00.08 PM
Screenshot 2025-11-16 at 1.00.08 PM892×506 55.8 KB

https://x.com/EricTopol/status/1990151981873463689?s=20

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#1149

Wow, I was going to do it anyway but if they’re throwing in $1000 that’s easy. Just working on my medicare today. 65 on the solstice.

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#1150

So, I take a lot of stuff… and a lot of stuff can ‘possibly’ lower ldl secondarily…

I mean, I think some of the prescriptions I take like telmisartan can do…

Also the non prescription stuff like high gram glycine/melatonin/vitamins (non synthetic)/some of the ingredients in my novos core may do as well