Belly fat doubles chance of dying for heart patients

Kathleen Blanchard's picture
Belly fat and heart disease

Patients with coronary artery disease and even a little belly fat are twice as likely to die, finds a large study from Mayo Clinic researchers

In the investigation that included 15,923 people with coronary artery disease from five separate studies, researchers found increased waist circumference is just as dangerous as smoking or high cholesterol for patients with coronary artery disease.

The results of the study, published in the Journal of the American College of Cardiology, also found patients with heart disease but normal body mass index (BMI) were more likely to die, despite past studies suggesting increased survival associated with higher BMI, compared to normal weight individuals.

The researchers suspect it may be the way fat is distributed in the body. Belly fat is associated with higher risk of diabetes and heart disease from past studies.


“Visceral fat has been found to be more metabolically active. It produces more changes in cholesterol, blood pressure and blood sugar. However, people who have fat mostly in other locations in the body, specifically, the legs and buttocks, don’t show this increased risk”, explained Francisco Lopez-Jimenez, M.D., director of the Cardiometabolic Program at Mayo Clinic and lead investigator of the study.

Waist to hip ratio is easily measured, and is suggested as a tool for clinicians to gauge the risk of dying from coronary artery disease, suggest the authors.

According to Thais Coutinho, M.D., the study’s lead author and a cardiology fellow at the Mayo Clinic, “BMI is just a measure of weight in proportion to height. What seems to be more important is how the fat is distributed on the body.”

The large study found just a little belly fat can be dangerous for patients with heart disease. Fat in the waist area doubled the chances of dying for coronary artery disease, according findings. The investigation included a variety of ethnic groups throughout the world.

J Am Coll Cardiol, 2011; 57:1877-1886, doi:10.1016/j.jacc.2010.11.058
"Central Obesity and Survival in Subjects With Coronary Artery Disease"
Thais Coutinho, MD et al.