Published online before print December 15, 2003, doi: 10.1161/01.CIR.0000108926.04022.0C
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(Circulation. 2004;109:42-46.)
© 2004 American Heart Association, Inc.
Clinical Investigation and Reports |
Association of the Metabolic Syndrome With History of Myocardial Infarction and Stroke in the Third National Health and Nutrition Examination Survey
From the Department of Family and Preventive Medicine (J.K.N., M.H.C., A.G.), University of California, San Diego, Calif; Ingenix Epidemiology (G.L.I.), Auburndale, Mass; and Bristol-Myers Squibb (J.L.W., R.S.C.), Pharmaceutical Research Institute, Princeton, NJ.
Correspondence to Michael H. Criqui, MD, MPH, University of California, San Diego, 9500 Gilman Dr, 352 SCRB, La Jolla, CA 92093-0607. E-mail mcriqui{at}ucsd.edu
Received April 2, 2003; de novo received July 1, 2003; revision received September 25, 2003; accepted September 25, 2003.
Background— The combination of cardiovascular risk factors known as the metabolic syndrome is receiving increased attention from physicians, but data on the syndrome’s association with morbidity are limited.
Methods and Results— Applying National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria, we evaluated 10 357 NHANES III subjects for the 5 component conditions of the metabolic syndrome: insulin resistance, abdominal obesity based on waist circumference, hypertriglyceridemia, low HDL cholesterol (HDL-C), and hypertension, as well as the full syndrome, defined as at least 3 of the 5 conditions. Logistic regression was used to estimate the cross-sectional association of the syndrome and each of its 5 component conditions separately with history of myocardial infarction (MI), stroke, and either MI or stroke (MI/stroke). Models were adjusted for age, sex, race, and cigarette smoking. The metabolic syndrome was significantly related in multivariate analysis to MI (OR, 2.01; 95% CI, 1.53 to 2.64), stroke (OR, 2.16; 95% CI, 1.48 to 3.16), and MI/stroke (OR, 2.05; 95% CI, 1.64 to 2.57). The syndrome was significantly associated with MI/stroke in both women and men. Among the component conditions, insulin resistance (OR, 1.30; 95% CI, 1.03 to 1.66), low HDL-C (OR, 1.35; 95% CI, 1.05 to 1.74), hypertension (OR, 1.44; 95% CI, 1.00 to 2.08), and hypertriglyceridemia (OR, 1.66; 95% CI=1.20 to 2.30) were independently and significantly related to MI/stroke.
Conclusions— These results indicate a strong, consistent relationship of the metabolic syndrome with prevalent MI and stroke.
Key Words: syndrome X • risk factors • myocardial infarction • stroke • epidemiology
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