Abdominal Obesity and Cardiovascular Health

Abdominal obesity, characterised by disproportionate accumulation of fat around the waist, is a potent determinant of cardiovascular morbidity and mortality. Unlike general adiposity measured by body mass index (BMI), central fat deposition—particularly visceral adiposity—promotes a pro-inflammatory milieu, insulin resistance, dyslipidaemia and hypertension. These pathophysiological processes accelerate atherosclerotic plaque formation, endothelial dysfunction and the risk of myocardial and cerebrovascular events. The global prevalence of abdominal obesity has risen markedly in recent decades, with notable variations across age, sex and ethnicity. Effective risk stratification requires routine assessment of waist circumference alongside conventional measures, and the integration of digital tools to enhance measurement accuracy. Interventions targeting central fat reduction through dietary modification, structured physical activity and emerging pharmacological therapies have demonstrated significant improvements in cardiometabolic outcomes. However, standardisation of measurement protocols and the establishment of population-specific threshold values remain urgent priorities to inform public-health policy and clinical practice.

Research from Nature Portfolio

Consensus guidelines now position waist circumference as an indispensable clinical “vital sign.” These recommendations emphasise that assessing central adiposity in conjunction with BMI substantially improves prediction of adverse cardiometabolic outcomes. Evidence indicates that even modest reductions in waist circumference—achieved through moderate-intensity exercise and tailored dietary regimens—produce clinically meaningful declines in blood pressure, blood glucose and lipid levels. The statement also calls for refinement of waist circumference threshold values across diverse demographic groups and for standardised practitioner training to ensure precise and reproducible measurements in clinical settings.

Abdominal Obesity and Cardiovascular Health publication trend

The graph below shows the total number of articles in abdominal obesity and cardiovascular health across all publications each year (not limited to Nature Index journals).

Technical terms

Abdominal obesity: Excessive accumulation of fat around the midsection, particularly within the abdominal cavity, associated with increased health risks.

Waist circumference (WC): A clinical measurement around the abdomen at a standardised anatomical landmark to assess central fat accumulation.

Waist-to-hip ratio (WHR): The proportion of waist circumference to hip circumference, reflecting the distribution of body fat between trunk and hips.

Visceral adiposity: Fat stored within the peritoneal cavity around internal organs, which is metabolically active and linked to cardiovascular and metabolic disease.

Cardiometabolic risk: The combined risk of cardiovascular disease and metabolic disorders, influenced by factors such as central adiposity, hypertension, dyslipidaemia and insulin resistance.

References

1. Development and validation of an accurate smartphone application for measuring waist-to-hip circumference ratio. npj Digital Medicine (2023).
2. General versus central adiposity as risk factors for cardiovascular-related outcomes in a high-risk population with type 2 diabetes: a post hoc analysis of the REWIND trial. Cardiovascular Diabetology (2023).
3. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nature Reviews Endocrinology (2020).
4. Trends in general and abdominal obesity in US adults: Evidence from the National Health and Nutrition Examination Survey (2001–2018). Frontiers in Public Health (2022).