Abstract 15485: The Natural History of Subjects with Isolated Metabolic Syndrome Compared to Metabolic Syndrome- a Population Based Study
Background: Metabolic syndrome (MS) as defined by the presence ≥3 ATP-NCEP-III criteria is associated with increased risk of cardiovascular disease and mortality. Isolated MS is defined as metabolic syndrome subjects that do not meet the diagnosis of hypertension and diabetes and are not on therapy for either, despite having elevated blood pressure and hyperglycemia.
Objectives: To determine the natural history of isolated MS as compared to those with MS.
Methods: Data was collected prospectively on a population-based random sample of 2042 Olmsted County, Minnesota, residents aged 45 years or older who underwent clinical evaluation, medical record abstraction, and echocardiography (Visit 1 [1997-2000]). After 4 years, participants returned for Visit 2 (2001-2004). From visit 2, we have a median (IQR) of 8.3 (7.3, 9.2) years of follow-up.
Results: We identified 232 subjects with isolated MS, 190 subjects with MS and compared them to 701 healthy controls. Subjects with isolated MS were older (61±9 years vs 59±9 years, p=<0.001), had higher prevalence of diastolic dysfunction (24% vs 16% p=0.003), higher LV mass index and higher aldosterone levels as compared to healthy controls (p<0.05). At visit 2, a greater percentage of subjects had developed new diagnoses of hypertension and diabetes in the Isolated MS group versus healthy controls (p<0.05). Patients with isolated MS had similar rates of mortality (p=0.12) or development of heart failure (HF) (p=0.64) as healthy controls over 8 years. Compared with subjects with isolated MS, subjects with MS were older, had more diastolic dysfunction (42% vs 24%, p=0.003), higher LV mass index and higher aldosterone levels (p<0.05). Patients with MS had higher rates of mortality (p=0.004) but not HF (p=0.11) than patients with isolated MS over 8 years.
Conclusion: Subjects with isolated MS have significant LV remodeling and neurohumoral activation as compared to healthy controls but less than those with MS. Isolated MS is associated with increased risk for the development of hypertension and diabetes but not increased mortality or development of HF over an 8 year period compared to healthy controls. Future studies should determine if aggressive management of risk factors in isolated MS will prevent the progression to MS.
Author Disclosures: P.A. Patel: None. C.G. Scott: None. R. Rodeheffer.: None. H. Chen: None.
- © 2014 by American Heart Association, Inc.