title: Ethnicity and genetics are more important than diabetes mellitus and hypertension in producing cardiovascular events in patients with the metabolic syndrome: emphasis in the Puerto Rico population.
abstract: Metabolic syndrome is a cluster of risk factors for cardiovascular disease that affects an estimated 50 million Americans. The present article reviews the metabolic syndrome with respect to its definition, epidemiology, pathophysiology and management. A primary focus in research has been to elucidate the processes determined to cause insulin resistance, the fundamental mechanism underlying the metabolic syndrome. Namely, the incidence, component characteristics and complications of the metabolic syndrome in the island of Puerto Rico are described alongside the fact that the metabolic syndrome may be milder in Puerto Rico than in the mainland United States because it is characterized by less aggressive coronary disease and a relatively normal lipid profile. This suggests that the cardiovascular complications are more influenced by genetics and culture than diabetes mellitus and hypertension.
authors.affiliation: Department of Medicine and Physiology, UPR School of Medicine, Medical Sciences Campus, San Juan, Puerto Rico. altierip@prtc.net
authors.forename: Pablo I
authors.initials: PI
authors.lastname: Altieri
authors.forename: José M
authors.initials: JM
authors.lastname: Marcial
authors.forename: Héctor
authors.initials: H
authors.lastname: Banchs
authors.forename: Nelson
authors.initials: N
authors.lastname: Escobales
authors.forename: María
authors.initials: M
authors.lastname: Crespo
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use; D050197:Atherosclerosis / Q000209:etiology; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000209:etiology* / Q000235:genetics; D002940:Circadian Rhythm; D003131:Combined Modality Therapy; D016207:Cytokines / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D038441:Diet, Mediterranean; D005081:Exercise Therapy; D020022:Genetic Predisposition to Disease; D006630:Hispanic or Latino / Q000235:genetics*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007249:Inflammation; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000150:complications* / Q000208:ethnology / Q000235:genetics / Q000503:physiopathology / Q000628:therapy; D011647:Puerto Rico / Q000208:ethnology; D012084:Renin-Angiotensin System / Q000502:physiology; D012307:Risk Factors; D045162:Thiazolidinediones / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology
chemical_list: D019440:Anti-Obesity Agents; D016207:Cytokines; D045162:Thiazolidinediones