Here’s More Evidence That Excess Belly Fat Can Mess With Your Heart

• According to new research published in the European Journal of Preventive Cardiology, having excess belly fat can increase your chances of having multiple heart attacks and even strokes, regardless of if you’re on preventative medication.
• A healthy diet and regular physical activity are the best ways to lower your risk of heart attack and stroke.

The association between excess abdominal fat and heart disease is well established at this point, and here’s the latest news surrounding the link between the two: Not only does this type of fat increase your risk of heart attack, but recent research suggests it also boosts the chances you’ll have subsequent heart attacks, and even strokes.

The study, published in the European Journal of Preventive Cardiology, followed more than 22,000 people who’d experienced a heart attack and looked at the relationship between abdominal obesity and recurrent cardiovascular disease issues, including heart attacks and strokes.

Those with more belly fat—which was measured by waist circumference—had higher risk of heart events, even when they were on medication or having therapy aimed at lowering heart attack risk, according to the study’s lead author, Hanieh Mohammadi, M.D., of the Department of Clinical Sciences and Education at the Karolinska Institute in Sweden.

In other words, the drugs used to lower lipids and blood pressure, as well as control diabetes, were significantly less effective at preventing a second cardiovascular event than having less belly fat.

“Maintaining a healthy waist circumference is important for preventing future heart attacks and strokes, regardless of how many preventive drugs you may be taking or how healthy your blood tests are,” she told Runner’s World.

That’s because abdominal obesity is a direct marker of visceral fat—which is the type of deeper fat that sits around your vital organs, according to Mohammadi. This kind is closely associated with cardiovascular and metabolic problems such as high blood pressure, raised blood lipids (fats), high blood sugar, and insulin resistance.

These conditions all cluster together to form metabolic syndrome, and each of them accelerates the clogging of arteries—especially when you have more than one of these issues. That clog can lead to heart attack and stroke.

Not only was this the largest study of secondary heart attack risk, but it is the first of its kind to analyze men and women separately, Mohammadi added. That led to insights about how abdominal obesity and risk were different for each.

“The association was linear in men, meaning increasing levels of abdominal obesity leads to increasing risk of recurrent heart attack or stroke,” she said. “But the pattern in women was U-shaped, which means patients with mid-range waist circumference had the lowest risk rather than those with the smallest or largest waist circumference.”

More research needs to be done to establish what that means for women, she said, but it may suggest that the association between belly fat and recurrent heart attacks and strokes is stronger in men—and that women may have more of the harmless abdominal fat instead.

But one thing is sure for both men and women, said Mohammadi: Healthy habits that lower fat, especially around the midsection, are crucial for boosting heart health. Even if you’re on medication aimed at cardiovascular improvement, it’s no substitute for good old balanced nutrition and regular physical activity.