Association of body fat-distribution markers with ischemic ECG changes and with 20-year all-cause and cardiovascular mortality in community-dwelling older adults

WWI showed the strongest association with mortality and should be considered the preferred marker for identifying abnormal fat distribution, potentially replacing BMI. Key messages What is already known on this topic: Body mass index (BMI) correlates poorly with visceral fat yet data on which body fat distribution markers is the strongest predictor of cardiovascular (CV) morbidity and mortality is lacking among older adults. What this study adds: Weight adjusted waist index (WWI) was the strongest predictor of ischemic ECG changes, all-cause and CV mortality, outperforming BMI. How this study might affect research, practice or policy: WWI should be considered the preferred marker for identifying abnormal fat distribution, screening individuals at risk and guide medical intervention for weight reduction, potentially replacing BMI.