A high risk score for coronary heart disease is associated with the metabolic syndrome in 40-year-old men and women.
OBJECTIVE
Guidelines recommend follow-up of people whose 10-year risk of coronary heart disease (CHD) is > 10%. We calculated CHD risk, number of risk factors and occurrence of the metabolic syndrome among screened 40-year-old men and women.


METHODS
A total of 1547 women and 1374 men participated in a cardiovascular risk factor screening programme in 1997-1999 in Oslo. Of 387 (13%) recalled for further examination and advice, 337 (87%) attended. We used the National Cholesterol Education Program criteria to define the metabolic syndrome and the Framingham risk score to assess absolute 10-year risk of CHD and counted nine risk factors (male, southeast-Asian origin, low education, smoking, premature familial cardiovascular disease (CVD), hypertension, high waist circumference, impaired fasting glucose or diabetes and high apolipoprotein B).


RESULTS
More than one-third of subjects recalled for hypertension (n = 88) or low high-density lipoprotein (HDL) cholesterol (n = 95) had the metabolic syndrome. Of 55 subjects with a 10-year risk score > 10%, 33 (60%) had the metabolic syndrome. Subjects with the metabolic syndrome had a higher risk score compared with their counterparts (P < 0.001); among men with the metabolic syndrome, the mean +/- SD risk score was 10.0 +/- 4.4%. Subjects with dyslipidaemia [high triglyceride and normal low-density lipoprotein (LDL) cholesterol levels] or combined hyperlipidaemia had a higher risk score and more risk factors compared with subjects with isolated high LDL cholesterol (P < 0.05). Only 12% of subjects with hypertension were taking drugs and of 237 subjects with a lipid disorder, 30% had been given dietary advice and one was taking a lipid-lowering drug.


CONCLUSIONS
CVD screening should focus on identifying people with features of the metabolic syndrome in this age group. The screening programme uncovered a substantial potential for CVD prevention.
Tonstad
Serena
S
Department of Preventive Cardiology, Ullevål University Hospital, Oslo, Norway. serena.tonstad@ulleval.no
Hjermann
Ingvar
I
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001824:Body Constitution; D015992:Body Mass Index; D002637:Chest Pain / Q000150:complications / Q000175:diagnosis; D008076:Cholesterol, HDL / Q000032:analysis*; D003327:Coronary Disease / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications* / Q000175:diagnosis; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000032:analysis
D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides