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The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study.

Abstract

OBJECTIVE

To assess the magnitude of the association between the National Cholesterol Education Program's Third Adult Treatment Panel Report (ATP III) definition of the metabolic syndrome and cardiovascular disease (CVD).

RESEARCH DESIGN AND METHODS

Cox regression was used to estimate the relative risk of incident coronary heart disease (CHD) and stroke among 12,089 black and white middle-aged individuals in the Atherosclerosis Risk in Communities (ARIC) study.

RESULTS

The metabolic syndrome was present in approximately 23% of individuals without diabetes or prevalent CVD at baseline. Over an average of 11 years of follow-up, 879 incident CHD and 216 ischemic stroke events occurred. Among the components of the metabolic syndrome, elevated blood pressure and low levels of HDL cholesterol exhibited the strongest associations with CHD. Men and women with the metabolic syndrome were approximately 1.5 and 2 times more likely to develop CHD than control subjects after adjustment for age, smoking, LDL cholesterol, and race/ARIC center (sex interaction P < 0.03). Similar associations were found between the metabolic syndrome and incident ischemic stroke. Comparison of receiver operating characteristic curves indicated that the metabolic syndrome did not materially improve CHD risk prediction beyond the level achieved by the Framingham Risk Score (FRS).

CONCLUSIONS

Individuals without diabetes or CVD, but with the metabolic syndrome, were at increased risk for long-term cardiovascular outcomes, although statistical models suggested that most of that risk was accounted for by the FRS. Nevertheless, identification of individuals with the metabolic syndrome may provide opportunities to intervene earlier in the development of shared disease pathways that predispose individuals to both CVD and diabetes.

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  • Authors+Show Affiliations

    ,

    University of North Carolina, Chapel Hill, 137 E. Franklin St, Chapel Hill, NC 28514, USA. wayne_rosamond@unc.edu

    , , , , , ,

    Source

    Diabetes care 28:2 2005 Feb pg 385-90

    MeSH

    African Continental Ancestry Group
    Arteriosclerosis
    Diabetes Mellitus, Type 2
    European Continental Ancestry Group
    Female
    Follow-Up Studies
    Humans
    Incidence
    Male
    Metabolic Syndrome
    Middle Aged
    Prevalence
    Proportional Hazards Models
    Risk Factors
    Stroke

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    15677797

    Citation

    McNeill, Ann Marie, et al. "The Metabolic Syndrome and 11-year Risk of Incident Cardiovascular Disease in the Atherosclerosis Risk in Communities Study." Diabetes Care, vol. 28, no. 2, 2005, pp. 385-90.
    McNeill AM, Rosamond WD, Girman CJ, et al. The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care. 2005;28(2):385-90.
    McNeill, A. M., Rosamond, W. D., Girman, C. J., Golden, S. H., Schmidt, M. I., East, H. E., ... Heiss, G. (2005). The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. Diabetes Care, 28(2), pp. 385-90.
    McNeill AM, et al. The Metabolic Syndrome and 11-year Risk of Incident Cardiovascular Disease in the Atherosclerosis Risk in Communities Study. Diabetes Care. 2005;28(2):385-90. PubMed PMID: 15677797.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study. AU - McNeill,Ann Marie, AU - Rosamond,Wayne D, AU - Girman,Cynthia J, AU - Golden,Sherita Hill, AU - Schmidt,Maria I, AU - East,Honey E, AU - Ballantyne,Christie M, AU - Heiss,Gerardo, PY - 2005/1/29/pubmed PY - 2005/6/1/medline PY - 2005/1/29/entrez SP - 385 EP - 90 JF - Diabetes care JO - Diabetes Care VL - 28 IS - 2 N2 - OBJECTIVE: To assess the magnitude of the association between the National Cholesterol Education Program's Third Adult Treatment Panel Report (ATP III) definition of the metabolic syndrome and cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS: Cox regression was used to estimate the relative risk of incident coronary heart disease (CHD) and stroke among 12,089 black and white middle-aged individuals in the Atherosclerosis Risk in Communities (ARIC) study. RESULTS: The metabolic syndrome was present in approximately 23% of individuals without diabetes or prevalent CVD at baseline. Over an average of 11 years of follow-up, 879 incident CHD and 216 ischemic stroke events occurred. Among the components of the metabolic syndrome, elevated blood pressure and low levels of HDL cholesterol exhibited the strongest associations with CHD. Men and women with the metabolic syndrome were approximately 1.5 and 2 times more likely to develop CHD than control subjects after adjustment for age, smoking, LDL cholesterol, and race/ARIC center (sex interaction P < 0.03). Similar associations were found between the metabolic syndrome and incident ischemic stroke. Comparison of receiver operating characteristic curves indicated that the metabolic syndrome did not materially improve CHD risk prediction beyond the level achieved by the Framingham Risk Score (FRS). CONCLUSIONS: Individuals without diabetes or CVD, but with the metabolic syndrome, were at increased risk for long-term cardiovascular outcomes, although statistical models suggested that most of that risk was accounted for by the FRS. Nevertheless, identification of individuals with the metabolic syndrome may provide opportunities to intervene earlier in the development of shared disease pathways that predispose individuals to both CVD and diabetes. SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/15677797/full_citation L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=15677797 DB - PRIME DP - Unbound Medicine ER -