title: Costs of the metabolic syndrome in elderly individuals: findings from the Cardiovascular Health Study.
abstract: OBJECTIVE
  The cardiovascular consequences of the metabolic syndrome and its component risk factors have been documented in elderly individuals. Little is known about how the metabolic syndrome and its individual components translate into long-term medical costs.
  
  
  METHODS
  We used log-linear regression models to assess the independent contributions of the metabolic syndrome and its individual components to 10-year medical costs among 3,789 individuals aged > or = 65 years in the Cardiovascular Health Study.
  
  
  RESULTS
  As defined by the National Cholesterol Education Program Third Adult Treatment Panel report, the metabolic syndrome was present in 47% of the sample. Total costs to Medicare were 20% higher among participants with the metabolic syndrome ($40,873 vs. $33,010; P < 0.001). Controlling for age, sex, race/ethnicity, and other covariates, we found that abdominal obesity, low HDL cholesterol, and elevated blood pressure were associated with 15% (95% CI 4.3-26.7), 16% (1.7-31.8), and 20% (10.1-31.7) higher costs, respectively. When added to the model, the metabolic syndrome composite variable did not contribute significantly (P = 0.32).
  
  
  CONCLUSIONS
  Abdominal obesity, low HDL cholesterol, and hypertension but not the metabolic syndrome per se are important predictors of long-term costs in the Medicare population.
authors.affiliation: Center for Clinical and Genetic Economics, Duke Clinical Research Institute, P.O. Box 17969, Durham, NC 27715, USA. lesley.curtis@duke.edu
authors.forename: Lesley H
authors.initials: LH
authors.lastname: Curtis
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Hammill
authors.forename: M Angelyn
authors.initials: MA
authors.lastname: Bethel
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Anstrom
authors.forename: John S
authors.initials: JS
authors.lastname: Gottdiener
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Schulman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D008076:Cholesterol, HDL / Q000097:blood; D017281:Cost of Illness; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007407:Interviews as Topic; D008297:Male; D006278:Medicare; D024821:Metabolic Syndrome / Q000191:economics*; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D010353:Patient Education as Topic; D011446:Prospective Studies; D044469:Racial Groups; D012044:Regression Analysis; D014481:United States / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL