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. Author manuscript; available in PMC: 2026 Aug 14.
Published in final edited form as: J Am Coll Cardiol. 2026 Aug 11;88(6):670–684. doi: 10.1016/j.jacc.2026.05.050

Table 2:

Population Attributable Fraction (PAF) of High Waist Circumference and High Waist-to-Hip Ratio within Body Mass Index Categories.

Normal Weight Overweight Obesity
High WC High WHR High WC High WHR High WC High WHR
MI 1.9% (1%, 2.9%) 10.5% (8.1%, 12.9%) 11.4% (9.2%, 13.6%) 22.2% (19%, 25.2%) 34% (25.5%, 41.6%) 19.7% (15.7%, 23.5%)
Stroke 2.4% (1.6%, 3.3%) 9.2% (7.1%, 11.2%) 9.9% (7.7%, 12.1%) 18.2% (15.7%, 20.6%) 31.7% (23.6%, 38.9%) 22.8% (19.8%, 25.6%)
HF 1.8% (0.4%, 3.2%) 9.7% (5.7%, 13.4%) 15.3% (12.7%, 17.9%) 23.7% (18.7%, 28.3%) 48.9% (41.2%, 55.6%) 27% (22.2%, 31.4%)
AF 1.7% (−0.3%, 3.6%) 6.4% (0.6%, 11.8%) 12.7% (8.9%, 16.4%) 5.4% (−4.7%, 14.5%) 46.2% (30.1%, 58.6%) 20.8% (9.4%, 30.7%)
CHD 2% (1.3%, 2.6%) 9.1% (7.6%, 10.6%) 10.6% (8.9%, 12.2%) 17.2% (15.1%, 19.2%) 35.4% (29.4%, 40.9%) 17.9% (15.3%, 20.5%)
CVD 1.7% (1.2%, 2.1%) 7% (5.9%, 8.1%) 10.1% (8.9%, 11.4%) 14.4% (12.8%, 15.9%) 32.5% (28%, 36.7%) 15.6% (13.7%, 17.5%)
CHD Mortality 2.1% (1.4%, 2.8%) 8.9% (7.2%, 10.6%) 11.2% (9%, 13.3%) 15.4% (12.8%, 17.9%) 36.3% (28.5%, 43.3%) 18.4% (15.1%, 21.5%)
CVD Mortality 1.8% (1.3%, 2.3%) 6.4% (5.2%, 7.6%) 11% (9.4%, 12.5%) 12% (10.1%, 13.8%) 36.6% (31.1%, 41.6%) 13.8% (11.4%, 16.2%)
All-Cause Mortality 1.2% (1%, 1.5%) 4.8% (4.2%, 5.3%) 9.7% (8.9%, 10.4%) 9.6% (8.7%, 10.5%) 28.8% (25.8%, 31.7%) 12.8% (11.5%, 13.9%)

Population attributable fractions were estimated using multivariable Cox proportional hazards models adjusted for age, sex, race and ethnicity, education, smoking status, and alcohol use, with a shared frailty term for cohort and site.

BMI categories were defined as the following: Normal weight: BMI 18.5 to <25.0 kg/m2, Overweight: BMI 25.0 to <30.0 kg/m2, Obesity: BMI ≥30.0 kg/m2.

High WC is defined as > 88cm for females, >102 cm for males and high WHR as > 0.85 for females, >0.90 for males.

BMI: body mass index; MI: myocardial infarction, HF: heart failure; AF: atrial fibrillation; CHD: coronary heart disease; CVD: cardiovascular disease, WC, Waist Circumference; WHR, Waist-to-Hip Ratio.