The Paris Prospective study stratified 7,079 asymptomatic, middle-aged men for sagittal abdominal diameter (SAD) and BMI, and followed them for clinical outcomes for an average of 23 years. The measured outcome was sudden death.

The risk of sudden death increased in parallel with increases in abdominal obesity (left panel). In contrast, the relationship between increasing BMI and risk of sudden death was flat for the first four tertiles, increasing only at the fifth, and highest tertile. These data suggest that SAD, the measure of abdominal obesity, was superior to BMI in predicting the risk of an adverse clinical outcome for most of the study participants.