Abdominal obesity—the phenomenon commonly known as “beer belly”—is associated with significant cardiovascular risks, according to new data being presented at RSNA 2025 in Chicago.
“Abdominal obesity, a high waist-to-hip ratio (WHR), is associated with more concerning cardiac remodeling patterns than high body mass index (BMI) alone,” lead author Jennifer Erley, MD, a radiology resident at University Medical Center Hamburg-Eppendorf in Germany, said in an RSNA statement.
“It appears to lead to a potentially pathological form of cardiac remodeling, concentric hypertrophy, where the heart muscle thickens but the overall size of the heart doesn’t increase, leading to smaller cardiac volumes. In fact, the inner chambers become smaller, so the heart holds and pumps less blood. This pattern impairs the heart’s ability to relax properly, which eventually can lead to heart failure.”
Erley et al. reviewed data from more than 2,200 adults between the ages of 46 and 78. All participants were part of the Hamburg City Health Study, and none of them had a history of known cardiovascular disease. Forty-three percent of participants were women.
While 69% of men and 56% women were overweight or obese based on BMI, those numbers were 91% and 64%, respectively, when using WHR. Overall, participants with a high WHR were associated with multiple heart changes only visible when reviewing advanced cardiac MRI results. This included a thickening of the heart muscle and smaller heart chamber volumes.
These risks were especially high in male participants. Researchers believe this is an early sign of cardiac stress, providing a helpful look at how abdominal fat impacts a person’s breathing and their lungs.
“The sex-specific differences suggest that male patients may be more vulnerable to the structural effects of obesity on the heart, a finding not widely reported in earlier studies,” Erley explained.
“Rather than focusing on reducing overall weight, middle-aged adults should focus on preventing abdominal fat accumulation through regular exercise, a balanced diet and timely medical intervention, if necessary.”
Erley also emphasized that radiologists and cardiologists alike should pay more attention to abdominal obesity and its potential impact on heart patients.
