Metabolic syndrome is a condition that has come into the spotlight over the last few years. It comprises a clustering of risk factors, including48:
- Abdominal obesity
- Atherogenic dyslipidemia (elevated triglycerides, small LDL particles, low HDL cholesterol)
- Raised blood pressure
- Insulin resistance or glucose intolerance (type 2 diabetes)
- Prothrombotic state (eg, increased fibrinogen or plasminogen activator inhibitor-1 blood level)
- Proinflammatory state (eg, elevated high-sensitivity C-reactive protein [CRP] blood level)
(For a discussion of how metabolic syndrome is diagnosed, see the Metabolic Syndrome page in the Special Issues section of this Web site.)
Metabolic syndrome is a predictor of cardiovascular disease. In the Framingham Heart Study, the presence of metabolic syndrome alone predicted almost 25% of all new-onset cardiovascular disease,48 and it is associated with a 3.0- to 4.3-fold increased risk for CHD mortality.49
In a recent multicenter registry study of patients undergoing stress myocardial perfusion imaging (MPI), patients with metabolic syndrome had a significantly lower 2-year event-free survival rate (84%) than those without the syndrome.50 Also, a significant additive relationship was seen between the number of metabolic syndrome risk factors present and the extent and severity of MPI abnormalities, with patients having 5 risk factors being at greatest risk.50 |
Risk Factors
Office-Based Risk Assessment
Risk Reduction
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