title: Effect of metabolic syndrome on heart attack and mortality in Mexican-American elderly persons: findings of 7-year follow-up from the Hispanic established population for the epidemiological study of the elderly.
abstract: OBJECTIVE
  We aim to examine the effect of Metabolic syndrome (MetS) on heart attack and overall mortality in Mexican-American elderly persons over 7-year follow-up.
  
  
  METHODS
  We studied 3050 Mexican Americans aged 65 or older from the Hispanic Established Population for the Epidemiological Study of the Elderly conducted in five Southwestern states of the United States. Participants were categorized into two groups: those with or without MetS. A total of 333 (11%) respondents at baseline had met the criteria of MetS (at least three of five characteristics--hyperinsulinemia or fasting plasma glucose > or =110 mg/dl, abdominal obesity, and hypertension--as defined by the World Health Organization).
  
  
  RESULTS
  Of 333 participants with MetS, the mean age was 71.1 years and 68% were females (compared with 73.2 years and 56% in those without MetS). Eighty percent of participants with MetS rated their health as fair or poor, compared to 55% of those participants without MetS. Fifty-four percent and 65% of patients with MetS had arthritis and at least one impairment in instrumental activities of daily living (IADL), compared to 39% and 55% of those participants without MetS. MetS was significantly associated with increased incidence of heart attack (odds ratio: 2.75, 95% confidence interval: 1.67-4.54) and was a significant predictor for overall mortality (hazard ratio: 1.46, 95% confidence interval: 1.16-1.84) over a 7-year period after adjusting for other demographic and clinical variables.
  
  
  CONCLUSIONS
  Among Mexican-American elderly participants, those with MetS had poorer self-rated health. MetS was significantly associated with increased incidence of heart attack and higher mortality over a 7-year period.
authors.affiliation: Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX 77555-1153, USA.
authors.forename: Max E
authors.initials: ME
authors.lastname: Otiniano
authors.forename: Xianglin L
authors.initials: XL
authors.lastname: Du
authors.forename: Mario R
authors.initials: MR
authors.lastname: Maldonado
authors.forename: Laura
authors.initials: L
authors.lastname: Ray
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Markides
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D001168:Arthritis / Q000453:epidemiology; D001294:Attitude to Health; D016021:Epidemiologic Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006946:Hyperinsulinism / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D017058:Mexican Americans / Q000706:statistics & numerical data*; D009203:Myocardial Infarction / Q000401:mortality*; D009765:Obesity / Q000453:epidemiology; D011159:Population Surveillance; D012737:Sex Factors; D015206:Southwestern United States / Q000453:epidemiology; D015996:Survival Rate