New research suggests that measures of excess weight around the waist may increase the risk of heart failure primarily due to inflammation, according to findings presented at the American Heart Association’s EPI|Lifestyle Scientific Sessions 2026. The study found that measurements of higher levels of visceral fat were more strongly linked to heart failure risk than overall body weight, and higher waist measurements identified higher risk even when body mass index (BMI) appeared normal.
“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. “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.”
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 study analyzed health data for 1,998 African American adults from the Jackson Heart Study. Participants were ages 35-84 years old at enrollment, with an average age of 58; 36% were women, and they were followed for a median of 6.9 years, through December 31, 2016. During that period, 112 adults developed heart failure. Elevated measurements of excess weight around the waist were associated with increased heart failure risk, while high BMI was not. Higher waist circumference and waist-to-height ratio were each associated with increased heart failure risk. Participants with higher inflammation levels, as measured by high-sensitivity C-reactive protein blood tests, were more likely to experience heart failure. Inflammation accounted for about one-quarter to one-third of the link between measures of fat stored around the waist and heart failure risk.
“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.” Khan, who was not involved in the study, is Magerstadt Professor of Cardiovascular Epidemiology and an associate professor of cardiology and preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago.
The researchers noted that they did not have access to participants’ heart failure subtypes, so the findings are about 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 the risk of heart failure.
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.
