JACC This Week November 18, 2025: Adiposity, Heart Failure, and the Future of Cardiometabolic Care | JACC This Week
Nov 10, 2025
Delve into the fascinating world of adiposity and its impact on heart health. Discover why waist-to-height ratios might be better predictors of heart failure than BMI. Learn about the extensive cardiovascular benefits of GLP-1 receptor agonists and how obesity affects biomarker interpretations. The role of visceral fat in chronic kidney disease is explored, alongside discussions of how diabetes intertwines with heart conditions. Insights into managing obesity in heart failure highlight the need for collaborative care in cardiometabolic health.
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Waist Measures Beat BMI For Risk
- Waist measures outperform BMI for predicting heart failure and mortality in HFmrEF/HFpEF trials.
- Many with BMI <30 had excess abdominal adiposity that BMI missed and that linked to higher risk.
BMI's J-Curve Masks True Adiposity Risk
- BMI shows a J- or U-shaped relationship with outcomes while waist-to-height ratio shows a linear risk increase.
- This suggests BMI misclassification may underlie the so-called obesity paradox.
Abdominal Obesity Predicts CV Events And Benefits
- In finerenone trials, measures of abdominal obesity were highly prevalent and predicted cardiovascular outcomes.
- Treatment effects were consistent across adiposity levels though absolute benefit rose with higher adiposity.