Showing posts with label Metabolic Syndrome. Show all posts
Showing posts with label Metabolic Syndrome. Show all posts
Tuesday, January 29, 2008
Diuretics Most Effective Blood Pressure Medication For People With Metabolic Syndrome
Commentaries:
The ALLHAT study originally reported in 2002 that diuretics were the most beneficial of the drug classes studied for treating high blood pressure and for protecting against adverse cardiovascular outcomes. The study compare a diuretic (chlorthalidone) with three classes of medications to treat high blood pressure: a calcium-channel blocker (amlodipine besylate), an alpha-blocker (doxazosin mesylate), and an angiotensin-converting enzyme (ACE) inhibitor (lisinopril).
Diuretic-based treatment was more protective against heart failure and also against overall cardiovascular disease (coronary heart disease, stroke, heart failure, or peripheral arterial disease combined) when compared with the ACE-inhibitor and alpha-blocker-based treatments.
Diuretic-based treatment was more protective against heart failure when compared with the calcium channel blocker-based treatment.
Clinical Outcomes by Race in Hypertensive Patients With and Without the Metabolic Syndrome Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
Jackson T. Wright Jr, MD, PhD; Sonja Harris-Haywood, MD; Sara Pressel, MS; Joshua Barzilay, MD; Charles Baimbridge, MS; Charles J. Bareis, MD; Jan N. Basile, MD; Henry R. Black, MD; Richard Dart, MD; Alok K. Gupta, MD; Bruce P. Hamilton, MD; Paula T. Einhorn, MD, MS; L. Julian Haywood, MD; Syed Z. A. Jafri, MD; Gail T. Louis, RN, BA; Paul K. Whelton, MD, MSc; Cranford L. Scott, MD; Debra L. Simmons, MD; Carol Stanford, MD; Barry R. Davis, MD, PhD
Arch Intern Med. 2008;168(2):207-217.
Background Antihypertensive drugs with favorable metabolic effects are advocated for first-line therapy in hypertensive patients with metabolic/cardiometabolic syndrome (MetS). We compared outcomes by race in hypertensive individuals with and without MetS treated with a thiazide-type diuretic (chlorthalidone), a calcium channel blocker (amlodipine besylate), an -blocker (doxazosin mesylate), or an angiotensin-converting enzyme inhibitor (lisinopril).
Methods A subgroup analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), a randomized, double-blind hypertension treatment trial of 42 418 participants. We defined MetS as hypertension plus at least 2 of the following: fasting serum glucose level of at least 100 mg/dL, body mass index (calculated as weight in kilograms divided by height in meters squared) of at least 30, fasting triglyceride levels of at least 150 mg/dL, and high-density lipoprotein cholesterol levels of less than 40 mg/dL in men or less than 50 mg/dL in women.
Results Significantly higher rates of heart failure were consistent across all treatment comparisons in those with MetS. Relative risks (RRs) were 1.50 (95% confidence interval, 1.18-1.90), 1.49 (1.17-1.90), and 1.88 (1.42-2.47) in black participants and 1.25 (1.06-1.47), 1.20 (1.01-1.41), and 1.82 (1.51-2.19) in nonblack participants for amlodipine, lisinopril, and doxazosin comparisons with chlorthalidone, respectively. Higher rates for combined cardiovascular disease were observed with lisinopril-chlorthalidone (RRs, 1.24 [1.09-1.40] and 1.10 [1.02-1.19], respectively) and doxazosin-chlorthalidone comparisons (RRs, 1.37 [1.19-1.58] and 1.18 [1.08-1.30], respectively) in black and nonblack participants with MetS. Higher rates of stroke were seen in black participants only (RR, 1.37 [1.07-1.76] for the lisinopril-chlorthalidone comparison, and RR, 1.49 [1.09-2.03] for the doxazosin-chlorthalidone comparison). Black patients with MetS also had higher rates of end-stage renal disease (RR, 1.70 [1.13-2.55]) with lisinopril compared with chlorthalidone.
Conclusions The ALLHAT findings fail to support the preference for calcium channel blockers, -blockers, or angiotensin-converting enzyme inhibitors compared with thiazide-type diuretics in patients with the MetS, despite their more favorable metabolic profiles. This was particularly true for black participants.
Saturday, August 18, 2007
Low socioeconomic status raises women’s metabolic syndrome risk
Low socioeconomic status raises women’s metabolic syndrome risk
By Eleanor McDermid
17 August 2007
Ann Epidemiol 2007; Advance online publication
MedWire News: Women with low socioeconomic status are at increased risk for the metabolic syndrome compared with their better-off peers, evidence from NHANES suggests.
“These findings provide physiologic mechanistic evidence for previously observed associations of income and education with risk for coronary heart disease,” the researchers write in the Annals of Epidemiology.
Eric Loucks (McGill University, Montreal, Canada) and colleagues studied data on 1407 women and 1527 men, aged 25 to 65 years, who participated in the 1999¬–2002 US National Health and Nutrition Examination Survey. They defined wealth according to the poverty income ratio (PIR), with a PIR of less than 1 indicating income below the official poverty line for the USA.
Women aged 25–45 and 46–65 years with income below the poverty line were, respectively, 4.90- and 2.54-fold more likely to have the metabolic syndrome than their wealthier counterparts.
Women with fewer than 12 years of education were at increased risk for the metabolic syndrome compared with better-educated women, at odds ratios of 2.77 and 2.50 for women in the younger and older age groups, respectively.
But socioeconomic status did not influence men’s risk for having the metabolic syndrome.
The team says this may be explained by research showing that women with low socioeconomic status are more likely than men to be single parents, depressed, unemployed, and have income below the poverty threshold.
Socioeconomic status also did not influence metabolic syndrome risk in adolescents and people aged over 65 years, regardless of gender.
The findings support “the importance of targeting intervention and prevention efforts toward economically and socially disadvantaged populations, particularly women,” Loucks et al conclude.
Journal
By Eleanor McDermid
17 August 2007
Ann Epidemiol 2007; Advance online publication
MedWire News: Women with low socioeconomic status are at increased risk for the metabolic syndrome compared with their better-off peers, evidence from NHANES suggests.
“These findings provide physiologic mechanistic evidence for previously observed associations of income and education with risk for coronary heart disease,” the researchers write in the Annals of Epidemiology.
Eric Loucks (McGill University, Montreal, Canada) and colleagues studied data on 1407 women and 1527 men, aged 25 to 65 years, who participated in the 1999¬–2002 US National Health and Nutrition Examination Survey. They defined wealth according to the poverty income ratio (PIR), with a PIR of less than 1 indicating income below the official poverty line for the USA.
Women aged 25–45 and 46–65 years with income below the poverty line were, respectively, 4.90- and 2.54-fold more likely to have the metabolic syndrome than their wealthier counterparts.
Women with fewer than 12 years of education were at increased risk for the metabolic syndrome compared with better-educated women, at odds ratios of 2.77 and 2.50 for women in the younger and older age groups, respectively.
But socioeconomic status did not influence men’s risk for having the metabolic syndrome.
The team says this may be explained by research showing that women with low socioeconomic status are more likely than men to be single parents, depressed, unemployed, and have income below the poverty threshold.
Socioeconomic status also did not influence metabolic syndrome risk in adolescents and people aged over 65 years, regardless of gender.
The findings support “the importance of targeting intervention and prevention efforts toward economically and socially disadvantaged populations, particularly women,” Loucks et al conclude.
Journal
Monday, August 13, 2007
Research suggests link between pediatric metabolic syndrome and adult heart disease
Obesity-Linked Woes Boost Kids' Lifetime Heart Risk'
Metabolic syndrome' includes higher blood pressure, cholesterol
By Alan MozesHealthDay Reporter
FRIDAY, Aug. 10 (HealthDay News) -- Obese children diagnosed with health problems collectively known as the "metabolic syndrome" are at higher risk for developing heart disease as adults, new research reveals.
Compared to healthier youngsters, school-age children with the condition face a 14.5 times greater risk of cardiovascular disease when they reached their 30s and 40s, the study found.
Components of the syndrome include high blood pressure, high body mass, high blood pressure and high triglycerides (blood fats).
The findings are published in the August issue of Pediatrics.
According to the American Heart Association, more than 50 million Americans have the metabolic syndrome. The condition is typically diagnosed on the basis of having at least three of the following characteristics: abdominal obesity; high blood pressure; insulin resistance (in which the body can't process insulin or blood sugar properly); a high risk for arterial plaque build-up due to high levels of triglycerides, low HDL ("good") cholesterol and high LDL ("bad") cholesterol; and a high risk for clotting and inflammation as indicated by the elevated presence of certain blood proteins.
Researchers long ago established that, for adults, having the metabolic syndrome increases their risk for both heart disease and diabetes. Physicians now recommend that patients combating the condition embark on a weight-loss program geared toward developing healthier eating habits and increased physical activity.
To explore a possible link between pediatric metabolic syndrome and adult heart disease, Morrison and his team cross-referenced data for contributing syndrome characteristics collected from a pool of 771 children between 1973 and 1978, and then again between 2000 and 2004.
The participants were drawn from the Cincinnati region and were between the ages of 6 and 19 in the first study and 30 and 48 in the follow-up study. A little less than three-quarters of the pool were white and a little more than a quarter were black.
Patient blood samples were taken the time of study enrollment and then 25 years later. The researchers gauged blood pressure; body mass index (BMI); and cholesterol. Blood triglyceride and glucose levels were also assessed.
The participants also reported any history of heart attack or stroke, or procedures such as coronary bypass or angioplasty.
Four percent of the participants -- 31 boys and girls -- had metabolic syndrome as children, while more than 25 percent had the condition 25 years later, the researchers reported.
Among those with pediatric metabolic syndrome, almost 70 percent still had the condition as adults, and almost 20 percent had gone on to develop cardiac disease in the intervening years.
In contrast, only 1.5 percent of the children who did not have the syndrome as kids went on to experience heart trouble as adults.
Furthermore, any rise or fall in BMI over the 25 years was linked to a concurrent rise or fall in risk for developing the metabolic syndrome. In that time frame, every BMI bump or drop of 10 points translated into a 24 percent risk increase or decrease for the syndrome, the team reported.
SOURCES:
John A. Morrison, Ph.D., research professor, pediatrics and division of cardiology, Cincinnati Children's Hospital Medical Center, Ohio; Brenda Kohn, M.D., associate professor, pediatrics, New York University School of Medicine, New York City, and member, medical advisory board, Juvenile Diabetes Foundation; August 2007, Pediatrics
Metabolic syndrome' includes higher blood pressure, cholesterol
By Alan MozesHealthDay Reporter
FRIDAY, Aug. 10 (HealthDay News) -- Obese children diagnosed with health problems collectively known as the "metabolic syndrome" are at higher risk for developing heart disease as adults, new research reveals.
Compared to healthier youngsters, school-age children with the condition face a 14.5 times greater risk of cardiovascular disease when they reached their 30s and 40s, the study found.
Components of the syndrome include high blood pressure, high body mass, high blood pressure and high triglycerides (blood fats).
The findings are published in the August issue of Pediatrics.
According to the American Heart Association, more than 50 million Americans have the metabolic syndrome. The condition is typically diagnosed on the basis of having at least three of the following characteristics: abdominal obesity; high blood pressure; insulin resistance (in which the body can't process insulin or blood sugar properly); a high risk for arterial plaque build-up due to high levels of triglycerides, low HDL ("good") cholesterol and high LDL ("bad") cholesterol; and a high risk for clotting and inflammation as indicated by the elevated presence of certain blood proteins.
Researchers long ago established that, for adults, having the metabolic syndrome increases their risk for both heart disease and diabetes. Physicians now recommend that patients combating the condition embark on a weight-loss program geared toward developing healthier eating habits and increased physical activity.
To explore a possible link between pediatric metabolic syndrome and adult heart disease, Morrison and his team cross-referenced data for contributing syndrome characteristics collected from a pool of 771 children between 1973 and 1978, and then again between 2000 and 2004.
The participants were drawn from the Cincinnati region and were between the ages of 6 and 19 in the first study and 30 and 48 in the follow-up study. A little less than three-quarters of the pool were white and a little more than a quarter were black.
Patient blood samples were taken the time of study enrollment and then 25 years later. The researchers gauged blood pressure; body mass index (BMI); and cholesterol. Blood triglyceride and glucose levels were also assessed.
The participants also reported any history of heart attack or stroke, or procedures such as coronary bypass or angioplasty.
Four percent of the participants -- 31 boys and girls -- had metabolic syndrome as children, while more than 25 percent had the condition 25 years later, the researchers reported.
Among those with pediatric metabolic syndrome, almost 70 percent still had the condition as adults, and almost 20 percent had gone on to develop cardiac disease in the intervening years.
In contrast, only 1.5 percent of the children who did not have the syndrome as kids went on to experience heart trouble as adults.
Furthermore, any rise or fall in BMI over the 25 years was linked to a concurrent rise or fall in risk for developing the metabolic syndrome. In that time frame, every BMI bump or drop of 10 points translated into a 24 percent risk increase or decrease for the syndrome, the team reported.
SOURCES:
John A. Morrison, Ph.D., research professor, pediatrics and division of cardiology, Cincinnati Children's Hospital Medical Center, Ohio; Brenda Kohn, M.D., associate professor, pediatrics, New York University School of Medicine, New York City, and member, medical advisory board, Juvenile Diabetes Foundation; August 2007, Pediatrics
Saturday, June 9, 2007
Metabolic Syndrome Linked to Compromised Heart Structure and Function
Metabolic Syndrome Linked to Compromised Heart Structure and Function
Review
PORTO, Portugal, June 7 -- As metabolic syndrome becomes more severe, symptomatic heart failure and several cardiac structural and functional abnormalities may increase progressively, researchers here reported.
This association was independent of the 10-year predicted risk of coronary heart disease by the standard Framingham risk score for indirect indices of diastolic dysfunction, although not systolic function, Ana Azevedo, Ph.D., of the University of Porto here, and colleagues reported online in BMC Cardiovascular Disorders.
There was been much debate about the usefulness of the metabolic syndrome in cardiovascular risk prediction, namely whether it adds information to that provided by its individual components, and whether it adds to alternative prediction tools, including the widely used Framingham risk score, Dr. Azevedo wrote.
The current findings came from a cross-sectional study of a random sample of the urban population of Porto, which included 684 participants, ages 45 or older, recruited from 2001 to 2003.
Data were collected by a structured clinical interview with a physician, ECG, and a transthoracic M-mode and 2D echocardiogram.
Metabolic syndrome was defined according to the National Cholesterol Education Program. It included:
Waist circumference more than 102 cm in men and more than 88 cm in women.
Fasting serum triglycerides of 150 mg/dL or more.
High-density lipoprotein (HDL) cholesterol of less than 40 mg/dL in men and less than 50 mg/dL in women.
High blood pressure: systolic blood pressure of 130 mm Hg or higher and/or diastolic blood pressure of 85 mm Hg or higher, antihypertensive drug treatment.
High glucose levels: fasting serum glucose pf 110 mg/dL or higher, or clinical diagnosis of diabetes.
The association between the number of features of the metabolic syndrome and the cardiac structural and functional abnormalities was adjusted for age and gender, the 10-year predicted risk of coronary heart disease by the Framingham risk score, and adjusting for age, gender, and systolic blood pressure.
There was a positive association between the number of elements in the metabolic syndrome and features of cardiac structure and function, with a consistent and statistically significant trend for all cardiac variables when adjusting for age and gender.
Measures of left-ventricular geometry patterns, left-atrial diameter, and diastolic dysfunction maintained this trend when taking into account the 10-year predicted risk of coronary heart disease by the Framingham score as an independent variable, while left ventricular systolic dysfunction did not, the researchers said.
Measures of left-ventricular diastolic dysfunction, and mean left-ventricular mass, left-ventricular diameter, and left-atrial diameter increased significantly with increasing numbers of metabolic syndrome features when additionally adjusting for systolic blood pressure as a continuous variable, the researchers reported. Left ventricular systolic dysfunction did not support this trend, they said.
Of all the participants, 19.7% had metabolic syndrome, which was more common among women than men.
High blood pressure was by far the most prevalent single component of the syndrome and affected about 75% of all participants. In this group 80% had hypertension (140/90 mmHg) or used antihypertensive medication.
Men had a higher predicted risk of coronary heart disease, according to the Framingham prediction score.
Cardiac abnormalities were also fairly common in this sample and heart failure (stage C) affected 8.4% of the women and 5.2% of the men.
Concurrence of the various components of the metabolic syndrome increased significantly with age and the syndrome was also significantly and strongly associated with the predicted 10-years risk of coronary heart disease by the Framingham score. Prevalence raged from 6.5 for one metabolic syndrome, for example, to 18.4 for four to five features (P for trend=0.002).
There was a positive association between the degree of the metabolic syndrome -- assessed as the number of concurrently present components -- and measures of cardiac structure (left-ventricular diameter and mass, posterior wall height and interventricular septum height) and function.
In a subsample analysis of 541 patients younger than 75 with no coronary heart disease, the adjusted prevalence of left ventricular systolic dysfunction increased with increasing degree of metabolic syndrome, but the association was not statistically significant (P for trend 0.19) when adjusting for the Framingham risk score, the researchers reported.
Importantly, the researchers said, early asymptomatic stages of cardiac dysfunction increased progressively with the severity of the metabolic syndrome, independent of systolic blood pressure.
The statistical association with increasing number of features of metabolic syndrome can be explained by the increasing impact of multiple independent risk factors and does not necessarily mean that there is synergism, the researchers said.
Given the tendency of individual factors to aggregate, the prevalence of each component in isolation was very low, except for high blood pressure. Therefore, it was not possible to estimate the sole effect of each factor, in comparison with the absence of all factors, the researchers said.
From the clinical and public health perspective, it has been questioned whether the metabolic syndrome improves cardiovascular risk prediction, beyond previously used tools such at the diabetes predicting model or the Framingham risk score for coronary heart disease, the researchers said.
One must keep in mind, they said, that coronary heart disease is not the only determinant of systolic and diastolic dysfunction. Adjusting for the Framingham risk score amounts to assessing the effect of features of the metabolic syndrome not considered in the Framingham score, such as obesity and triglycerides, among other features, the researchers noted.
If there is increasing insulin resistance with increasing degree of metabolic syndrome, there might be a mitogenic stimulus for cardiac hypertrophy, the researchers wrote. It is not surprising therefore that cardiac structural features were significantly associated with increasing severity of the metabolic syndrome, even when adjusting for the Framingham risk score.
The main limitation of the study, the investigators said, is its relatively small sample size leading to few outcomes in certain categories, such as left ventricular systolic dysfunction, and difficulty assessing interactions within the metabolic syndrome. The cross-sectional design was also not the ideal approach for assessing causality.
Given that increasing concurrence of the metabolic syndrome factors might be only a proxy for higher blood pressure, it is a strength of this study that the reported associations were not explained by blood pressure level, the researchers said.
This association between the metabolic syndrome and compromised structure and function of the heart was independent of the 10-year predicted risk of coronary heat disease by the Framingham risk score for indirect indices of diastolic dysfunction, although not systolic function, the investigators said.
"Metabolic syndrome may help predict and increased cardiovascular risk beyond that predicted by the more frequently use Framingham risk score," Dr. Azevedo wrote.
No financial disclosures were reported. The study was funded by the Science and Technology Foundation.
Primary source: BMC Cardiovascular DisordersSource reference: Azevedo A, et al "Increasing number of components of the metabolic syndrome and cardiac structural and functional abnormalities: cross-sectional study of the general population" BMC Cardiovascular Disorders 2007.
Review
PORTO, Portugal, June 7 -- As metabolic syndrome becomes more severe, symptomatic heart failure and several cardiac structural and functional abnormalities may increase progressively, researchers here reported.
This association was independent of the 10-year predicted risk of coronary heart disease by the standard Framingham risk score for indirect indices of diastolic dysfunction, although not systolic function, Ana Azevedo, Ph.D., of the University of Porto here, and colleagues reported online in BMC Cardiovascular Disorders.
There was been much debate about the usefulness of the metabolic syndrome in cardiovascular risk prediction, namely whether it adds information to that provided by its individual components, and whether it adds to alternative prediction tools, including the widely used Framingham risk score, Dr. Azevedo wrote.
The current findings came from a cross-sectional study of a random sample of the urban population of Porto, which included 684 participants, ages 45 or older, recruited from 2001 to 2003.
Data were collected by a structured clinical interview with a physician, ECG, and a transthoracic M-mode and 2D echocardiogram.
Metabolic syndrome was defined according to the National Cholesterol Education Program. It included:
Waist circumference more than 102 cm in men and more than 88 cm in women.
Fasting serum triglycerides of 150 mg/dL or more.
High-density lipoprotein (HDL) cholesterol of less than 40 mg/dL in men and less than 50 mg/dL in women.
High blood pressure: systolic blood pressure of 130 mm Hg or higher and/or diastolic blood pressure of 85 mm Hg or higher, antihypertensive drug treatment.
High glucose levels: fasting serum glucose pf 110 mg/dL or higher, or clinical diagnosis of diabetes.
The association between the number of features of the metabolic syndrome and the cardiac structural and functional abnormalities was adjusted for age and gender, the 10-year predicted risk of coronary heart disease by the Framingham risk score, and adjusting for age, gender, and systolic blood pressure.
There was a positive association between the number of elements in the metabolic syndrome and features of cardiac structure and function, with a consistent and statistically significant trend for all cardiac variables when adjusting for age and gender.
Measures of left-ventricular geometry patterns, left-atrial diameter, and diastolic dysfunction maintained this trend when taking into account the 10-year predicted risk of coronary heart disease by the Framingham score as an independent variable, while left ventricular systolic dysfunction did not, the researchers said.
Measures of left-ventricular diastolic dysfunction, and mean left-ventricular mass, left-ventricular diameter, and left-atrial diameter increased significantly with increasing numbers of metabolic syndrome features when additionally adjusting for systolic blood pressure as a continuous variable, the researchers reported. Left ventricular systolic dysfunction did not support this trend, they said.
Of all the participants, 19.7% had metabolic syndrome, which was more common among women than men.
High blood pressure was by far the most prevalent single component of the syndrome and affected about 75% of all participants. In this group 80% had hypertension (140/90 mmHg) or used antihypertensive medication.
Men had a higher predicted risk of coronary heart disease, according to the Framingham prediction score.
Cardiac abnormalities were also fairly common in this sample and heart failure (stage C) affected 8.4% of the women and 5.2% of the men.
Concurrence of the various components of the metabolic syndrome increased significantly with age and the syndrome was also significantly and strongly associated with the predicted 10-years risk of coronary heart disease by the Framingham score. Prevalence raged from 6.5 for one metabolic syndrome, for example, to 18.4 for four to five features (P for trend=0.002).
There was a positive association between the degree of the metabolic syndrome -- assessed as the number of concurrently present components -- and measures of cardiac structure (left-ventricular diameter and mass, posterior wall height and interventricular septum height) and function.
In a subsample analysis of 541 patients younger than 75 with no coronary heart disease, the adjusted prevalence of left ventricular systolic dysfunction increased with increasing degree of metabolic syndrome, but the association was not statistically significant (P for trend 0.19) when adjusting for the Framingham risk score, the researchers reported.
Importantly, the researchers said, early asymptomatic stages of cardiac dysfunction increased progressively with the severity of the metabolic syndrome, independent of systolic blood pressure.
The statistical association with increasing number of features of metabolic syndrome can be explained by the increasing impact of multiple independent risk factors and does not necessarily mean that there is synergism, the researchers said.
Given the tendency of individual factors to aggregate, the prevalence of each component in isolation was very low, except for high blood pressure. Therefore, it was not possible to estimate the sole effect of each factor, in comparison with the absence of all factors, the researchers said.
From the clinical and public health perspective, it has been questioned whether the metabolic syndrome improves cardiovascular risk prediction, beyond previously used tools such at the diabetes predicting model or the Framingham risk score for coronary heart disease, the researchers said.
One must keep in mind, they said, that coronary heart disease is not the only determinant of systolic and diastolic dysfunction. Adjusting for the Framingham risk score amounts to assessing the effect of features of the metabolic syndrome not considered in the Framingham score, such as obesity and triglycerides, among other features, the researchers noted.
If there is increasing insulin resistance with increasing degree of metabolic syndrome, there might be a mitogenic stimulus for cardiac hypertrophy, the researchers wrote. It is not surprising therefore that cardiac structural features were significantly associated with increasing severity of the metabolic syndrome, even when adjusting for the Framingham risk score.
The main limitation of the study, the investigators said, is its relatively small sample size leading to few outcomes in certain categories, such as left ventricular systolic dysfunction, and difficulty assessing interactions within the metabolic syndrome. The cross-sectional design was also not the ideal approach for assessing causality.
Given that increasing concurrence of the metabolic syndrome factors might be only a proxy for higher blood pressure, it is a strength of this study that the reported associations were not explained by blood pressure level, the researchers said.
This association between the metabolic syndrome and compromised structure and function of the heart was independent of the 10-year predicted risk of coronary heat disease by the Framingham risk score for indirect indices of diastolic dysfunction, although not systolic function, the investigators said.
"Metabolic syndrome may help predict and increased cardiovascular risk beyond that predicted by the more frequently use Framingham risk score," Dr. Azevedo wrote.
No financial disclosures were reported. The study was funded by the Science and Technology Foundation.
Primary source: BMC Cardiovascular DisordersSource reference: Azevedo A, et al "Increasing number of components of the metabolic syndrome and cardiac structural and functional abnormalities: cross-sectional study of the general population" BMC Cardiovascular Disorders 2007.
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