Body Roundness Index Linked to Higher Heart Attack Risk

Key findings at a glance

• • Study population: 395,831 adults aged 40–70 years from the UK Biobank.
  • Follow-up: Median of 13.3 years, during which researchers recorded 14,419 myocardial infarction (MI) events.
  • Main finding: Participants in the highest body roundness index (BRI) quartile had a 52% higher adjusted hazard of heart attack than those in the lowest quartile.
  • Predictive performance: BRI showed slightly better discrimination than five other anthropometric measures, but its advantage was modest.
  • Clinical relevance: BRI may help assess abdominal adiposity, but further validation is necessary before routine clinical adoption.
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Quick Summary: A UK Biobank study of nearly 396,000 adults found that a higher body roundness index (BRI) was associated with increased heart attack risk. BRI showed slightly better predictive performance than five other anthropometric measures, although its clinical advantage remains uncertain.

Could Body Roundness Index Help Identify Heart Attack Risk?

Body roundness index (BRI) was associated with a higher risk of myocardial infarction (MI) in a large UK Biobank study, raising interest in waist-based measurements for cardiovascular risk assessment. Researchers analyzed data from 395,831 adults aged 40–70 years to compare BRI with body mass index (BMI), waist circumference (WC), weight-adjusted waist index (WWI), body surface area (BSA), and A Body Shape Index (ABSI).

Published in the Journal of Health, Population and Nutrition, the study examined whether these six anthropometric measures could help identify adults at greater risk of a first recorded heart attack. The researchers followed participants for a median of 13.3 years and recorded 14,419 MI events.

Conventional measurements have limitations. BMI does not distinguish regional fat distribution, while waist circumference cannot differentiate visceral fat from subcutaneous abdominal fat. BRI combines height and waist circumference to estimate body roundness and abdominal adiposity, offering another way to assess body composition indirectly.

What Did the Study Find About BRI and Heart Attack Risk?

Participants in the highest BRI quartile had a 52% higher adjusted hazard of heart attack than those in the lowest quartile. Each standard deviation increase in BRI was associated with a 13% higher adjusted hazard.

Other measurements showed similar associations. The highest versus lowest quartiles of WWI and waist circumference were associated with 46% and 40% higher adjusted hazards, respectively. BMI and ABSI were each associated with a 32% higher adjusted hazard. BSA did not show a significant association with MI risk.

BRI also showed the highest area under the receiver operating characteristic curve (AUC), at 0.710. The other measures ranged from 0.697 to 0.708. However, BRI’s advantage over WWI was only 0.002 AUC points, indicating a small difference in predictive performance.

Sex-stratified analyses showed that BRI remained the top-performing measure in males, while BRI and WWI performed comparably in females. The researchers suggested that sex-related differences in fat distribution might contribute to these findings, but the study did not directly measure visceral fat or test this mechanism.

What Do These Findings Mean for Clinical Practice?

For physicians, nurses, and other healthcare professionals, BRI may offer a simple, inexpensive way to estimate abdominal adiposity. However, the findings establish an association, not causation, and do not demonstrate that BRI-guided screening prevents heart attacks or improves patient outcomes.

The study also relied on baseline measurements and a predominantly White, self-selected UK Biobank population, limiting generalizability. Researchers noted that further validation in independent, diverse cohorts is necessary before routine clinical adoption.

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The takeaway: BRI may complement cardiovascular risk assessment, but its modest predictive advantage does not yet establish superiority for clinical decision-making. Future studies should determine whether adding BRI to existing cardiovascular risk scores meaningfully improves prediction

Source:

Springer Nature