Chau K, et al. - In this prospective analysis of initially healthy adults aged 30–60 from Eastern France enrolled in the STANISLAS population-based cohort, researchers investigated the metabolic and inflammatory features that could predict diastolic dysfunction (DD), as assessed twenty years later (2011–2016) by echocardiography using current international guidelines. For replication purposes, 1463 subjects from the Malmö Preventive Project cohort were analyzed. Body mass index (BMI), waist circumference (WC), waist-hip ratio, systolic blood pressure and triglycerides (TG) were identified as significant predictors of DD in age-sex-adjusted logistic models. Overall, a higher long-term DD risk could be observed in subjects with elevated WC and TG. The incidence of DD may be attenuated via prevention targeting visceral obesity.