New Delhi: Measuring belly fat may be more important than checking Body Mass Index (BMI) in predicting future heart complications among people with obstructive sleep apnea (OSA) and existing cardiovascular disease, according to a new study published in the August 2026 edition of the Journal of the American Academy of Neurology.
The findings have been highlighted by Dr. Manjari Tripathi, Neurologist, AIIMS New Delhi. The study analysed data from the international Sleep Apnea Cardiovascular Endpoints (SAVE) Trial, involving 2,662 adults with moderate-to-severe OSA and established cardiovascular disease, who were followed for an average of 3.7 years.
Researchers found that while 31.8% of participants were classified as obese using BMI (≥30 kg/m²), as many as 95.6% had central obesity, measured by the waist-to-height ratio (WHtR). The analysis showed that people in the highest WHtR group had a 52% higher risk of recurrent cardiovascular events than those in the lowest group. In contrast, BMI did not show a consistent association with future heart events, suggesting that relying solely on BMI may overlook cardiovascular risk in patients with sleep apnea.
The study also found that the cardiovascular benefits and adherence to continuous positive airway pressure (CPAP) therapy were similar across different obesity categories, indicating that body fat distribution did not alter CPAP’s effectiveness. The researchers concluded that waist-to-height ratio is a more reliable indicator of cardiovascular risk than BMI in patients with obstructive sleep apnea and heart disease and recommend incorporating central obesity measurements into routine cardiovascular risk assessment.
