Abstract 19615: The Gender Differences in the Natural History of Subjects With Isolated 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. The gender differences in the natural history of isolated MS remain undefined.
Objectives: To determine the gender differences in the natural history of isolated 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 a median (IQR) of 4.0 (3.9, 4.1) 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. Isolated MS was defined by non-hypertensive or non-diabetic subjects with ≥3 ATP-NCEP-III criteria.
Results: We identified 232 (133M, 99F) subjects with isolated MS and compared them to 701 (305M, 396F) healthy controls. At baseline, women with isolated MS, but not men, had higher diastolic dysfunction (32% vs 15%, p<0.001) and higher LV mass index (91.6±17.2 vs 86.6±15.3 g/m2, p=0.01) compared to controls. At baseline, men with isolated MS, but not women, had higher prevalence of GFR< 60 ml/min (16% vs 8%,p=0.012) compared to controls. At visit 2, the women with isolated MS had a greater percentage of subjects that had developed new diagnoses of hypertension as compared to the men (46% vs 32% p=0.021). Moreover, more women with isolated MS developed worsening of diastolic dysfunction (43% vs 24% p=0.003) than men with isolated MS. Women and men with isolated MS had similar rates of mortality or development of heart failure (HF) as healthy controls over 8 years.
Conclusion: Women with isolated MS have increased LV remodeling and diastolic dysfunction as compared to men. After 4 years, more women with isolated MS developed hypertension associated with worsening diastolic dysfunction as compared to men. These data suggest that therapeutic approaches for isolated MS need to account for the gender differences.
Author Disclosures: P.A. Patel: None. C. Scott: None. R. Rodeheffer: None. H. Chen: None.
- © 2014 by American Heart Association, Inc.