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Is Prediction of Cardiovascular Disease and All-cause Mortality Genuinely Driven by the Metabolic Syndrome, and Independently from its Component Variables? The Dubbo Study.
MedLine Citation:
PMID:  21353637     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The Metabolic Syndrome (MetS) predicts an increased risk of cardiovascular disease and all-cause mortality. Is this prediction genuinely driven by the syndrome and independently from its component variables? METHODS: A longitudinal cohort study in Dubbo, Australia of 2805 men and women ≥60 years followed for 16 years from 1988. Cox proportional hazards models were calculated for coronary heart disease (CHD), ischaemic stroke and all-cause mortality with MetS as an independent variable. Separate models included the MetS variable, with or without the presence of one of its five component variables. RESULTS: MetS was present in 33% of subjects. Obesity was present in 43% of those with MetS, high blood pressure in 99%, elevated triglycerides in 83%, low HDL-C in 75% and glycaemia in 48%. With respect to CHD and all-cause mortality, prediction by MetS was similar in the presence or absence of individual component factors (e.g. hazard ratio (95% CI) for CHD by MetS when low HDL-C present 1.60(1.39-1.84) and 1.67(1.37-2.04) when low HDL-C absent). With stroke, prediction by MetS was lost in the absence of elevated triglycerides or glycaemia factors (e.g. hazard ratio for stroke by MetS when glycaemia present 1.59(1.24-2.05) and 1.08(0.82-1.42) when glycaemia absent). CONCLUSIONS: The findings suggest that prediction of CHD and all-cause mortality is genuinely driven by the MetS and independently of its component variables. Prediction of ischaemic stroke is more complex, with some components providing prediction independently from the MetS.
Authors:
Leon A Simons; Judith Simons; Yechiel Friedlander; John McCallum
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-23
Journal Detail:
Title:  Heart, lung & circulation     Volume:  -     ISSN:  1444-2892     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963739     Medline TA:  Heart Lung Circ     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier B.V. All rights reserved.
Affiliation:
University of NSW, Lipid Research Department, St Vincent's Hospital, Sydney, NSW 2010, Australia.
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