Relation of the number of metabolic syndrome risk factors with all-cause and cardiovascular mortality.
The metabolic syndrome (MS) is a constellation of risk factors associated with diabetes and cardiovascular disease. This syndrome consists of at least 3 parameters assessing central obesity, hypertension, high-density lipoprotein cholesterol, triglycerides, and impaired glucose metabolism. Whether persons with 4 or 5 risk factors are at higher risk than those with 3 risk factors is unclear. Also unclear is whether those without the MS but with 1 or 2 risk factors warrant therapy. We assessed cardiovascular and all-cause mortality as a function of the number of these risk factors. We followed 30,365 men for a median follow-up of 13.6 years. During follow-up, 1,449 participants died, 527 from cardiovascular causes. All of the individual parameters defining the MS were significantly associated with both all-cause and cardiovascular mortality (p <0.001). After adjustment for age and the other MS variables, hypertension was the most potent risk factor whereas central obesity and hypertriglyceridemia remained associated with both all-cause and cardiovascular mortality. A highly significant trend was also noted between both all-cause or cardiovascular mortality and the number of risk factors (p <0.001 for trend). Risk increased incrementally, beginning at 1 risk factor for cardiovascular mortality and at 2 risk factors for all-cause mortality. In conclusion, there is a continuum of risk as the number of metabolic syndrome risk factors increases. These findings add to the growing evidence that central obesity can independently and adversely affect health.
Ho
John S
JS
Cooper Clinic, Dallas, Texas, USA. jsho@cooper-clinic.com
Cannaday
John J
JJ
Barlow
Carolyn E
CE
Mitchell
Tedd L
TL
Cooper
Kenneth H
KH
FitzGerald
Shannon J
SJ
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000401:mortality*; D008076:Cholesterol, HDL / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors
D001786:Blood Glucose; D008076:Cholesterol, HDL