Risk for cardiovascular disease associated with metabolic syndrome and its components: a 13-year prospective study in the RIVANA cohort

Abstract

Background We aimed to investigate the association of metabolic syndrome (MetS) and its single components with cardiovascular risk and estimated their impact on the prematurity of occurrence of cardiovascular events using rate advancement periods (RAPs). Methods We performed prospective analyses among 3976 participants (age range: 35–84, 55% female) in the Vascular Risk in Navarre (RIVANA) Study, a Mediterranean population-based cohort. MetS was defined based on the modified criteria of the American Heart Association/National Heart, Lung, and Blood Institute and the International Diabetes Federation. The primary endpoint was major cardiovascular event (a composite of myocardial infarction, stroke, or mortality from cardiovascular causes). Secondary endpoints were incidence of non-fatal myocardial infarction and non-fatal stroke, cardiovascular mortality, and all-cause mortality. Cox proportional hazards models, adjusted for potential confounders, were fitted to evaluate the association between MetS and its single components at baseline with primary and secondary endpoints. Results During a median follow-up of 12.8 years (interquartile range, 12.5–13.1), we identified 228 primary endpoint events. MetS was associated with higher risk of incidence of major cardiovascular event, cardiovascular and all-cause mortality, but was neither associated with higher risk of myocardial infarction nor stroke. Compared with participants without MetS, the multivariable hazard ratio (95% confidence interval [CI]) among participants with MetS was 1.32 (1.01–1.74) with RAP (95% CI) of 3.23 years (0.03, 6.42) for major cardiovascular event, 1.64 (1.03–2.60) with RAP of 3.73 years (0.02, 7.45) for cardiovascular mortality, and 1.45 (1.17–1.80) with RAP of 3.24 years (1.21, 5.27) for all-cause mortality. The magnitude of the associations of the single components of MetS was similar than the predicted by MetS. Additionally, for each additional trait of MetS, incidence of major cardiovascular event relatively increased by 22% (1.22, 95% CI 1.09–1.36) with RAP of 2.31 years (0.88, 3.74). Conclusions MetS was independently associated with CVD risk, cardiovascular and all-cause mortality. Components of the MetS were associated with similar magnitude of increased CVD, which suggests that MetS was not in excess of the level explained by the presence of its single components. Further research should explore the association of different combinations of the components of MetS with CVD.

The association between dietary acid load with cardiometabolic risk factors and inflammatory markers amongst elderly men: A cross‐sectional study

“…It is suggested that MetS is an important risk factor for CVD incidence and mortality, as well as all‐cause mortality 47,48 . The present study found a positive association between high DAL (NEAP score) with MetS.…”

Metabolic Syndrome, Its Components and Risk of Cardiometabolic Multimorbidity: Findings From the UK Biobank Cohort

“…From the National Health and Nutrition Examination Survey data, more than a fth of U.S. adults met the criterion of MetS [12] and its prevalence is projected to still increase following the increasing proportion of central obesity and aging population [13,14]. Moreover, large amounts of evidence showed that MetS and its components signi cantly increased the risk of single cardiometabolic diseases and mortality from cardiovascular diseases [15][16][17][18]. These ndings may suggest that MetS could in uence the development of cardiometabolic multimorbidity, but to date, no studies have examined whether and the extent to which MetS and its components are associated with cardiometabolic multimorbidity.…”

The risk of carotid plaque instability in patients with metabolic syndrome is higher in women with hypertriglyceridemia

“…Previous clinical studies have consistently demonstrated a significant association between MetS and incidence of ischemic stroke [ 2 , 6 , 23 ]. However, the relationship between MetS and the morphological characteristics of carotid plaque instability remains uncertain.…”