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Higher body roundness index associates with cardiovascular disease high-risk status in Chinese adultsYour Waist Shape Might Predict Heart Disease Risk

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Key Takeaway
Note that higher body roundness index associates with cardiovascular disease high-risk status in this cross-sectional study.

This cross-sectional study assessed 6,858 participants aged 35–75 years enrolled in a community-based health screening program in Luohe, Henan, China. The primary exposure was the body roundness index (BRI), evaluated for its association with WHO-defined cardiovascular disease (CVD) high-risk status, defined as an estimated 10-year risk ≥20%. Approximately 1,489 (22%) of participants were classified as having high CVD risk.

In fully adjusted models, higher BRI remained associated with high-risk status. However, receiver operating characteristic (ROC) analysis indicated that BRI offered only modest standalone discrimination for CVD risk. Additionally, machine-learning analysis demonstrated that BRI was retained among selected predictors and contributed meaningfully within the multivariable model.

No adverse events, discontinuations, or tolerability data were reported as this was an observational screening study. Limitations include subgroup analyses suggesting heterogeneity by sex and cardiometabolic strata. The study design precludes causal inference, and certainty regarding the association was not reported. Consequently, BRI may serve as a low-cost adjunct marker to prioritize individuals for comprehensive risk evaluation in primary-care screening settings.

Why Weight Alone Fails

Doctors usually use BMI to check risk. This measures height and weight together to give a score. But weight does not show where fat sits on your body.

Heart disease often hides in belly fat, not just total pounds. A person can be heavy but healthy. Another can be light but carry hidden risk.

The Surprising Shape Shift

A new index looks at your waist and height together. It calls this the Body Roundness Index, or BRI. Researchers say this shape matters more than scale numbers.

This tool helps spot risk earlier than old methods. It focuses on how your body is built. It adds new information to the mix.

How Shape Tells the Story

Think of your body like a balloon. Some balloons are tall and thin. Others are round and wide.

A rounder shape often means more fat around vital organs. This fat acts like a traffic jam for blood flow. It makes the heart work harder than it should.

BRI measures this roundness using waist and height. It is simple and does not need special machines.

Researchers looked at nearly 7,000 adults in China. They checked their bodies and heart risks over one year. The study focused on adults aged 35 to 75 years old.

They found that people with a rounder shape had higher risk. About 22 percent of the group was high risk. Machine learning helped confirm these findings.

The link held true even after adjusting for other factors. This means shape is a strong signal on its own.

This does not mean this treatment is available yet.

Heart disease is a top cause of death worldwide. Finding it early saves lives. Current tools sometimes miss people who are at risk.

This new measure could catch them sooner. It helps doctors decide who needs a full checkup. It is a low-cost way to screen people.

What Experts Are Saying

Scientists say this is a helpful tool for screening. It is not a replacement for blood tests or scans.

Machine learning helped confirm these findings. The data showed a clear link between shape and risk. It adds value to existing medical checks.

You cannot use this at home right now. Doctors need to measure it carefully.

If you are over 35, talk to your doctor about your risk. Focus on healthy habits like walking and eating well. Small changes can lower your risk over time.

The Catch You Need to Know

This study was done in one specific group of people. Results might look different in other parts of the world.

The study was a snapshot in time. It did not track changes over many years. We need more data to be sure.

The Road Ahead for Patients

More studies are needed to confirm these results. Researchers want to see if this works for everyone.

Approval for new tools takes time and careful testing. Wait for official guidelines before making changes.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundEfficient identification of individuals at high cardiovascular disease (CVD) risk is essential for prevention in middle-aged and older adults. The body roundness index (BRI), derived from waist circumference and height, may capture body-shape-related risk beyond conventional measures. We examined the association of BRI with World Health Organization (WHO)-defined CVD high-risk status in a community-based screening population.MethodsThis cross-sectional study used baseline data from the Luohe branch of the ChinaHEART cohort, a community-based health screening program in Luohe, Henan, China (March 2021 to February 2022), including adults aged 35–75 years. WHO-defined CVD high-risk status was determined using WHO CVD risk charts, with an estimated 10-year risk ≥20% classified as high risk. BRI was analyzed as a continuous variable (per 1-unit increase), quartiles, and a binary variable using a receiver operating characteristic (ROC)-derived threshold. Multivariable logistic regression, restricted cubic splines, ROC analysis with bootstrap confidence intervals, and subgroup/interaction analyses were performed. An explainable machine-learning workflow (LASSO, random forest, and SHAP) was also applied.ResultsAmong 6,858 participants, 1,489 (22%) were classified as WHO-defined CVD high risk. Higher BRI remained associated with high-risk status in fully adjusted models. ROC analysis showed only modest standalone discrimination, while subgroup analyses suggested heterogeneity by sex and cardiometabolic strata. In machine-learning analyses, BRI was retained among selected predictors and contributed meaningfully within the multivariable model.ConclusionIn this community screening population, BRI was positively associated with WHO-defined CVD high-risk status and may serve as a low-cost adjunct marker to prioritize individuals for comprehensive risk evaluation in primary-care screening settings.
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