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Metabolic syndrome and cardiovascular disease in older people: The cardiovascular health study.
J Am Geriatr Soc 2006; 54(9):1317-24JA

Abstract

OBJECTIVES

To assess the prospective association between metabolic syndrome (MetS) and cardiovascular disease (CVD) in older people and to evaluate the effect of lowering the threshold for impaired fasting glucose (IFG) on the prevalence of IFG and MetS and the risk of CVD.

DESIGN

Prospective cohort study.

SETTING

Four field centers in U.S. communities.

PARTICIPANTS

Three thousand five hundred eighty-five subjects in the Cardiovascular Health Study free of diabetes mellitus and CVD at baseline (mean age 72, 62% female, 14% black).

MEASUREMENTS

Baseline measures of MetS components and adjudicated incident CVD events. MetS (2001) was defined first using the original criteria from the Third Adult Treatment Panel Report of the National Cholesterol Education Program (> or =3 of the following: large waist circumference (women >88 cm, men >102 cm), elevated triglycerides (> or =1.70 mmol/L), low high-density lipoprotein cholesterol (men <1.04 mmol/L, women <1.30 mmol/L), elevated fasting glucose (6.1-6.9 mmol/L), and high blood pressure (> or =130/85 mmHg or self-reported use of medications for hypertension). Subjects were also classified according to the revised definition of the MetS (2005) that applies the lower threshold for fasting glucose (5.6-6.9 mmol/L).

RESULTS

During follow-up (median 11 years), 818 coronary heart disease (CHD), 401 stroke, and 554 congestive heart failure (CHF) events occurred. Age- and race-adjusted hazard ratios (HRs) for CHD, stroke, and CHF were 1.30 (95% confidence interval (CI) = 1.07-1.57), 0.94 (95% CI = 0.73-1.21), and 1.40 (95% CI = 1.12-1.76) for women and 1.35 (95% CI = 1.10-1.66), 1.51 (95% CI = 1.08-2.12), and 1.47 (95% CI = 1.14-1.90) for men, respectively. Overall, women and men with MetS (2005) were 20% to 30% more likely to experience any CVD event than subjects without MetS (2005). Using the lower cut-point for IFG resulted in a near tripling in IFG prevalence (16% to 46%) and an additional 9% classified with MetS (2005) but HRs similar to those estimated from the original MetS (2001) criteria. High blood pressure was the component most strongly associated with incident CHD.

CONCLUSION

Results from this study of an elderly, population-based cohort provide support for earlier investigations in primarily middle-aged populations that link the presence of MetS with the development of CVD and further underscore the importance of recognizing and treating its individual components, particularly high blood pressure.

Authors+Show Affiliations

Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina 27514, USA. am_mcneill@alumni.unc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

16970637

Citation

McNeill, Ann Marie, et al. "Metabolic Syndrome and Cardiovascular Disease in Older People: the Cardiovascular Health Study." Journal of the American Geriatrics Society, vol. 54, no. 9, 2006, pp. 1317-24.
McNeill AM, Katz R, Girman CJ, et al. Metabolic syndrome and cardiovascular disease in older people: The cardiovascular health study. J Am Geriatr Soc. 2006;54(9):1317-24.
McNeill, A. M., Katz, R., Girman, C. J., Rosamond, W. D., Wagenknecht, L. E., Barzilay, J. I., ... Jackson, S. A. (2006). Metabolic syndrome and cardiovascular disease in older people: The cardiovascular health study. Journal of the American Geriatrics Society, 54(9), pp. 1317-24.
McNeill AM, et al. Metabolic Syndrome and Cardiovascular Disease in Older People: the Cardiovascular Health Study. J Am Geriatr Soc. 2006;54(9):1317-24. PubMed PMID: 16970637.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic syndrome and cardiovascular disease in older people: The cardiovascular health study. AU - McNeill,Ann Marie, AU - Katz,Ronit, AU - Girman,Cynthia J, AU - Rosamond,Wayne D, AU - Wagenknecht,Lynne E, AU - Barzilay,Joshua I, AU - Tracy,Russell P, AU - Savage,Peter J, AU - Jackson,Sharon A, PY - 2006/9/15/pubmed PY - 2006/10/21/medline PY - 2006/9/15/entrez SP - 1317 EP - 24 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 54 IS - 9 N2 - OBJECTIVES: To assess the prospective association between metabolic syndrome (MetS) and cardiovascular disease (CVD) in older people and to evaluate the effect of lowering the threshold for impaired fasting glucose (IFG) on the prevalence of IFG and MetS and the risk of CVD. DESIGN: Prospective cohort study. SETTING: Four field centers in U.S. communities. PARTICIPANTS: Three thousand five hundred eighty-five subjects in the Cardiovascular Health Study free of diabetes mellitus and CVD at baseline (mean age 72, 62% female, 14% black). MEASUREMENTS: Baseline measures of MetS components and adjudicated incident CVD events. MetS (2001) was defined first using the original criteria from the Third Adult Treatment Panel Report of the National Cholesterol Education Program (> or =3 of the following: large waist circumference (women >88 cm, men >102 cm), elevated triglycerides (> or =1.70 mmol/L), low high-density lipoprotein cholesterol (men <1.04 mmol/L, women <1.30 mmol/L), elevated fasting glucose (6.1-6.9 mmol/L), and high blood pressure (> or =130/85 mmHg or self-reported use of medications for hypertension). Subjects were also classified according to the revised definition of the MetS (2005) that applies the lower threshold for fasting glucose (5.6-6.9 mmol/L). RESULTS: During follow-up (median 11 years), 818 coronary heart disease (CHD), 401 stroke, and 554 congestive heart failure (CHF) events occurred. Age- and race-adjusted hazard ratios (HRs) for CHD, stroke, and CHF were 1.30 (95% confidence interval (CI) = 1.07-1.57), 0.94 (95% CI = 0.73-1.21), and 1.40 (95% CI = 1.12-1.76) for women and 1.35 (95% CI = 1.10-1.66), 1.51 (95% CI = 1.08-2.12), and 1.47 (95% CI = 1.14-1.90) for men, respectively. Overall, women and men with MetS (2005) were 20% to 30% more likely to experience any CVD event than subjects without MetS (2005). Using the lower cut-point for IFG resulted in a near tripling in IFG prevalence (16% to 46%) and an additional 9% classified with MetS (2005) but HRs similar to those estimated from the original MetS (2001) criteria. High blood pressure was the component most strongly associated with incident CHD. CONCLUSION: Results from this study of an elderly, population-based cohort provide support for earlier investigations in primarily middle-aged populations that link the presence of MetS with the development of CVD and further underscore the importance of recognizing and treating its individual components, particularly high blood pressure. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/16970637/Metabolic_syndrome_and_cardiovascular_disease_in_older_people:_The_cardiovascular_health_study_ L2 - https://doi.org/10.1111/j.1532-5415.2006.00862.x DB - PRIME DP - Unbound Medicine ER -