Waist-to-hip ratio (WHR) and other measures of abdominal obesity are better indicators of cerebrovascular risk than BMI, according to a study conducted at the University of Heidelberg in Germany.

Investigators reached this conclusion after evaluating 379 people who had just had an ischemic stroke, intracerebral hemorrhage, or transient ischemic attack. The researchers looked at:


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  • BMI (with the pre-obesity range as 25.0-29.9 and obesity >30)
  • WHR (obesity defined as >0.85 for women and >1.0 for men)
  • Waist circumference (men were considered overweight if their waist measured at navel level was 37-40.1 in and obese thereafter, and women were deemed overweight at 31.5-34.6 in and obese thereafter )
  • Waist-to-stature ratio (waist circumference divided by body height).


Those with a higher WHR had nearly eight times the cerebrovascular risk of those with the lowest such measurement (Stroke. 2008;39:3145-3151). Waist circumference was also a valuable indicator: Men with a waist larger than 40.2 inches and women with a waist larger than 34.6 inches were more than four times more likely to suffer cerebrovascular problems than were control cases. However, the association between BMI and cerebrovascular risk was deemed insignificant after adjusting for physical inactivity, smoking, hypertension, and diabetes.