Metabolic syndrome, its preeminent clusters, incident coronary heart disease and all‐cause mortality – results of prospective analysis for the Atherosclerosis Risk in Communities study

Abstract

Objective. To investigate the prospective association between Metabolic Syndrome (MetS) and coronary heart disease (CHD) and all-cause mortality.Subjects and Design. A bi-racial cohort of 14 699 middle-aged Americans from the Atherosclerosis Risk in Communities study were followed for the development of new CHD and death over a period of 9 years. MetS, using the original ATP-III criteria, was defined as having at least three of the following components: elevated blood pressure (BP), elevated plasma glucose, elevated blood triglyceride (TG), increased waist circumference, and low HDL cholesterol (HDL-c). Incident CHD cases included hospitalized myocardial infarction (MI), fatal CHD, revascularization procedures, and silent MI as detected by EKG.Results. The prevalence of the MetS at baseline was 29%, 30%, 40% and 26% among CHD-free white women, white men, black women, and black men, respectively. There were 1018 incident CHD cases and 1039 deaths. The relative risk (RR) and 95% confidence interval (CI) of incident CHD associated with MetS was 2.46 (1.99, 3.03) for women and 1.86 (1.59, 2.18) for men. Clear dose-response relationship between the number of MetS components and incidence of CHD was found (P for linear trend <0.001).The following three clusters of MetS components posed the highest risk for CHD: (i) the elevated BP and glucose and low HDL-c group [RR ¼ 5.68 (3.44, 9.37)]; (ii) the elevated BP and glucose and TG group [RR ¼ 5.08 (2.96, 8.70)]; and (iii) the elevated BP and TG and low HDL-c group [RR ¼ 3.98 (2.75, 5.77)]. When all five components co-existed, the risk was the highest [RR ¼ 6.24 (4.65, 8.36)]. Similar results with attenuated RR were found for all-cause mortality.Conclusions. Individuals, especially women, with the MetS have significantly higher risk of developing CHD. The riskiest combination is high-BP and glucose clustered with low HDL-c or high TG. These data highlight the importance of targeting MetS in the prevention of CHD and premature death.

Metabolic Syndrome Clusters and the Risk of Incident Stroke

“…29 Published studies performed by our group have looked at the association of MetS with the risk of incident coronary heart diseases and all-cause mortality in the ARIC population. 30 For the purpose of this particular study, we used similar approaches like those shown by Hong et al 30 to look at MetS and the risk of incident stroke in the ARIC cohort.…”

Prevalence of Obesity, Type II Diabetes Mellitus, Hyperlipidemia, and Hypertension in the United States: Findings from the GE Centricity Electronic Medical Record Database

“…[8][9][10][11][12][13] Among the more prominent data sets are those of the Framingham Study, including the Framingham Offspring Study, in the United States, and the General Practice Research Database in the United Kingdom, the largest non-US database of ''anonymized'' primary care medical records. 14,15 Turning to the effects of body mass index (BMI) and obesity, Bays and colleagues 16 explored the relationships between BMI and prevalence of diabetes, hypertension, and dyslipidemia, examined BMI distributions among patients with these conditions, and compared results from 2 national surveys: (1) the screening questionnaire-based 2004 Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD), and (2) the interview, clinical, and laboratory data of the 1999-2002 National Health and Nutrition Examination Surveys (NHANES).…”

Clustering and combining pattern of metabolic syndrome components in a rural Brazilian adult population

“…Additionally, longitudinal studies have demonstrated variations in the risk of mortality according to the different combination patterns of metabolic syndrome components. 29,30 In our study, we observed that the most frequent We believe that our findings have a social impact because the study population was still undergoing the process of epidemiological transition, i.e. high rates of morbidity and mortality due to infectious and parasitic diseases 35 were observed to coexist with increased occurrence of non-communicable illnesses.…”