title: The metabolic syndrome predicts incident congestive heart failure: a 20-year follow-up study of elderly Finns.
abstract: OBJECTIVE
  We investigated whether the metabolic syndrome (MetS) and its components defined by four different criteria including subjects with prevalent diabetes in their definitions were associated with congestive heart failure (CHF) independent of interim myocardial infarction (MI) and prevalent diabetes during a 20-year follow-up in an elderly population-based study.
  
  
  RESULTS
  The MetS was defined according to the World Health Organization (WHO), the National Cholesterol Education Program (NCEP), the International Diabetes Federation (IDF), and the American Heart Association and the National Heart, Lung, and Blood Institute (AHA) criteria. The association of the MetS with incident CHF (303 cases) was investigated with Cox regression analyses in a 20-year follow-up study of 1032 Finns, aged 65-74 years at baseline. Among all subjects the MetS by all four criteria was significantly associated with a 1.45-1.74-fold risk for incident CHF after the adjustment for confounding factors. When subjects with interim MI during the follow-up and with prevalent diabetes were excluded, the MetS was significantly associated with a 1.37-1.87-fold risk for incident CHF after the adjustment for confounding factors. Of the single components of the MetS, the following were associated with incident CHF: impaired fasting glucose (IFG) [fasting plasma glucose (FPG)> or = 6.1 mmol/l, Hazards ratio (HR) 1.46 or FPG > or = 5.6 mmol/l, HR 1.62)]; raised blood pressure (BP) [(BP > or = 140/90 mmHg or antihypertensive medications, HR 1.89); central obesity (waist circumference > or = 94 cm in men or > or = 80 cm in women, HR 1.49); (waist circumference > or = 102 cm in men or > or = 88 cm in women, HR 1.48); obesity (body mass index > or = 30 kg/m(2), HR 1.79); and low high-density lipoprotein cholesterol (<1.03 mmol/l in men or <1.29 mmol/l in women, HR 1.55).
  
  
  CONCLUSIONS
  The MetS defined by four different criteria predicted CHF independent of interim MI and prevalent diabetes in elderly Finns, but not above and beyond the risk associated with one component of the MetS, hypertension.
authors: Department of Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland.
authors: Jianjun
authors: J
authors: Wang
authors: Katriina
authors: K
authors: Sarnola
authors: Sanna
authors: S
authors: Ruotsalainen
authors: Leena
authors: L
authors: Moilanen
authors: Päivi
authors: P
authors: Lepistö
authors: Markku
authors: M
authors: Laakso
authors: Johanna
authors: J
authors: Kuusisto
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D009765:Obesity / Q000150:complications; D044465:White People
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL