Cardio-oncology & otherCohort study

Beyond body mass index (BMI): the predictive value of body roundness index for cardiovascular mortality and related disparities: a national cohort study of US adults

Eur J Prev CardiolPublished

  • Prospective cohort study
  • national cohort
  • NHANES 1999-2018
  • weighted Cox proportional hazards
  • restricted cubic spline

Authors' conclusion

Higher BRI is independently associated with increased cardiovascular mortality, particularly among middle aged adults and those with normal BMI, underscoring its potential as a practical, noninvasive tool for cardiovascular risk stratification.

Study context

Population
US adults aged >20 years in NHANES 1999–2018 without prior CVD or cancer883 CV deaths
Participants
31,351 adults
Exposure
Highest vs middle Body Roundness Index (BRI) quintile
Outcome
CV mortality
Follow-up
Median 10.1 years (IQR: 5.3-14.9 years)

Main finding

As reported in the abstract

Hazard ratio

1.54

95% CI 1.13–2.08

P = 0.006

Q5 vs Q3
HR 1.54 (95% CI 1.13–2.08); P = 0.006

Observational data: associations, not effects.

Secondary outcomes

CV mortality, normal BMI (subgroup)

Risk remained high even among those with normal BMI

Shape of BRI–CV mortality association (restricted cubic spline (RCS))

Modest U-shaped association

CV mortality by age and education (subgroups)

Stronger effects among middle-aged adults (45-64 years) and those with higher educational attainment

Original publication

Beyond BMI: the predictive value of body roundness index for cardiovascular mortality and related disparities: a national cohort study of US adults. Eur J Prev Cardiol. Published 30 January 2026. doi:10.1093/eurjpc/zwag055

Summarised from the published abstract; every number is checked against it