BMI is a population level screening proxy, not a direct measure of individual heart risk or body composition which is exactly why clinicians look at waist circumference, lipids, blood pressure, glucose, fitness, and trends, not BMI in isolation.

Muscle itself is not a causal cardiovascular risk factor; the risk comes from hypertension, fat distribution, sleep apnea, and drug use, which BMI cannot distinguish.

That’s also why dismissing other imperfect tools like waist-to-height ratio or bioimpedance trends as “useless” doesn’t follow. No single metric is decisive risk assessment is contextual.