Men carrying excess abdominal fat, commonly known as a “beer belly,” may face a significantly higher risk of developing serious heart disease. Recent research presented at the Radiological Society of North America (RSNA) annual meeting highlights the strong connection between abdominal obesity and adverse changes in heart structure that can contribute to heart failure.
The study, led by Jennifer Erley from the University Medical Centre Hamburg-Eppendorf in Germany, analyzed cardiovascular MRI scans of 2,244 adults aged 46 to 78 with no known cardiovascular diseases. The findings reveal that a high waist-to-hip ratio — a key indicator of abdominal obesity — is linked to more dangerous patterns of cardiac remodeling than body mass index (BMI) alone.
Specifically, abdominal obesity was associated with a form of cardiac remodeling called concentric hypertrophy, where heart muscle thickens without an increase in overall heart size. This results in smaller heart chambers that hold and pump less blood, impairing the heart’s ability to relax and ultimately increasing the risk of heart failure.
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The study further noted that 91% of men and 64% of women in the study met the World Health Organization’s (WHO) criteria for abdominal obesity based on waist-to-hip ratio, even though only 69% of men and 56% of women were classified as overweight or obese according to BMI.
Men showed more pronounced heart muscle thickening and reduced chamber capacity, particularly in the right ventricle, which pumps blood to the lungs. Researchers suggest that excess belly fat may strain respiratory function and lung pressure, contributing to early cardiac stress.
Importantly, these cardiac changes were detectable through advanced MRI and remained significant after adjusting for other cardiovascular risk factors such as high blood pressure, smoking, diabetes, and cholesterol.
Dr. Erley emphasizes that middle-aged adults should prioritize preventing abdominal fat buildup through regular exercise, a balanced diet, and timely medical care rather than focusing solely on overall weight reduction. She also calls for further research to better understand these sex-specific cardiac effects.
Calculating your waist-to-hip ratio is simple: measure your waist at its narrowest point, your hips at their widest, then divide waist measurement by hip measurement. According to WHO guidelines, a ratio above 0.90 for men or 0.85 for women signals abdominal obesity and heightened cardiovascular risk.
This study adds to growing evidence linking abdominal fat to serious health risks. For instance, 2024 research published in Neurology connects elevated abdominal fat with a 13% higher risk of dementia—including Alzheimer’s and Parkinson’s diseases.
Overall, the findings underscore the critical importance of managing abdominal obesity to protect heart health and prevent life-threatening complications.