Metabolic Syndrome Strongly Linked to MI and Stroke

April 01, 2003

Martha Kerr

April 1, 2003 (Chicago) -- Patients with the constellation of five factors that constitute the metabolic syndrome -- insulin resistance, hypertension, hypertriglyceridemia, abdominal obesity, and low high-density lipoprotein cholesterol levels -- have more than double the risk of myocardial infarction (MI) and stroke compared with those without metabolic syndrome, according to new research presented here.

At the 52nd annual scientific session of the American College of Cardiology, John K. Ninomiya, MSc, of the Department of Family and Preventive Medicine at the University of California, San Diego, presented data from the National Health And Nutrition Examination Survey III (NHANES III) that showed the link between metabolic syndrome and stroke and MI risk.

Mr. Ninomiya and colleagues analyzed data on 10,357 individuals collected between 1988 and 1994 in NHANES III according to NCEP Adult Treatment Panel III criteria. Participants were defined as having metabolic syndrome if they had at least three of the five conditions.

The prevalence of MI in the study group was 3.7% and stroke prevalence was 2%. Metabolic syndrome was associated with an odds ratio of 2.01 for MI, 2.16 for stroke, and 2.05 for the combined outcome. The risk of stroke and MI was the same in both men and women.

Mr. Ninomiya said that all of the individual components of metabolic syndrome were "independently and significantly" related to stroke and MI risk except for obesity. "Obesity is related to all the other factors so it washes out" on adjustment of risk, he told meeting attendees.

"These findings reaffirm the importance of the traditional cardiovascular risk factors for MI and stroke," Mr. Ninomiya said.

In an interview with Medscape, Gerald Fletcher, MD, professor of medicine at the Mayo Clinic in Jacksonville, Florida, and an American Heart Association spokesperson, pointed out that "Metabolic syndrome entails all the risk factors for MI and stroke."

"The treatment is very simple -- exercise and diet. But people won't do it," Dr. Fletcher said. I don't want to say frighten people, but they need to watch their risk factors. It's a terrible problem.

"We need to address the issue of MI and stroke conjointly," Dr. Fletcher added. He emphasized that lipid levels need to be controlled with niacin or lipid-lowering agents, and low-density lipoprotein cholesterol levels need to be kept below 100 mg/dL. He advised stringent use of aspirin therapy and diet and exercise. "There is no magic here," he said.

ACC 52nd Annual Scientific Session: Abstract 845-6. Presented March 31, 2003.

Reviewed by Gary D. Vogin, MD

Martha Kerr is a freelance writer for Medscape.

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