Comparative evaluation of waist-to-height ratio and body mass index as predictors of cardiovascular risk among urban adults in Hyderabad, Telangana: a cross-sectional study

Background: Obesity is an important modifiable determinant of cardiovascular disease. Body mass index (BMI), although widely used, does not adequately reflect abdominal adiposity. Waist-to-height ratio (WHtR) may provide a simple alternative for identifying individuals with increased cardiometabolic risk. The aim of the study is to compare WHtR and BMI as predictors of cardiovascular risk among urban adults in Hyderabad, Telangana. Methods: This cross-sectional study included 70 adults aged 18-60 years. Anthropometric parameters, blood pressure, fasting plasma glucose, and lipid profile were assessed. BMI and WHtR were calculated using standard formulae. Cardiovascular risk was assessed based on the presence of cardiometabolic abnormalities. Receiver operating characteristic (ROC) analysis was performed to compare the discriminatory ability of BMI and WHtR. Results: The mean age was 41.6±10.8 years. Elevated WHtR (≥0.50) was observed in 45 (64.3%) participants, while 39 (55.7%) had BMI ≥25 kg/m². Participants with elevated WHtR demonstrated a greater burden of hypertension, dysglycemia, and dyslipidaemia. WHtR showed a higher area under the ROC curve than BMI (0.82 vs 0.71) for identifying increased cardiovascular risk. Conclusions: WHtR demonstrated better discriminatory ability than BMI for identifying cardiovascular risk and may serve as a simple screening measure in urban Indian adults.