Metabolic Syndrome and the Risk of Cardiovascular Disease in Older Adults

• Published in: Journal of the American College of Cardiology 2006-04, Vol.47 (8), p.1595-1602
• Main Authors: Butler, Javed, Rodondi, Nicolas, Zhu, Yuwei, Figaro, Kathleen, Fazio, Sergio, Vaughan, Douglas E., Satterfield, Suzanne, Newman, Anne B., Goodpaster, Bret, Bauer, Douglas C., Holvoet, Paul, Harris, Tamara B., de Rekeneire, Nathalie, Rubin, Susan, Ding, Jingzhong, Kritchevsky, Stephen B.
• Format: Article
• Language: English
• Subjects: Aged; Aging; Cardiac Output, Low - etiology; Cardiology; Cardiovascular disease; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Cholesterol; Cohort Studies; Coronary Disease - etiology; Diabetes Complications; European Continental Ancestry Group - statistics & numerical data; Female; Heart attacks; Hospitalization - statistics & numerical data; Hospitals; Humans; Male; Metabolic syndrome; Metabolic Syndrome - complications; Mortality; Myocardial Infarction - etiology; Older people; Proportional Hazards Models; Risk Assessment; Sex Distribution
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2005.12.046

Metabolic Syndrome and the Risk of Cardiovascular Disease in Older Adults Javed Butler, Nicolas Rodondi, Yuwei Zhu, Kathleen Figaro, Sergio Fazio, Douglas E. Vaughan, Suzanne Satterfield, Anne B. Newman, Bret Goodpaster, Doug Bauer, Paul Holvoet, Tamara B. Harris, Nathalie de Rekeneire, Susan Rubin, Jingzhong Ding, Stephen B. Kritchevsky, for the Health ABC Study To assess whether metabolic syndrome (MetSyn) predicts a risk for cardiovascular events in older adults, we studied 3,035 subjects, ages 70 to 79 years. After adjustment for other risk factors, during a 6-year follow-up, MetSyn was associated with a significantly higher risk for coronary events (hazard ratio [HR] 1.56, 95% confidence interval [CI] 1.28 to 1.91), myocardial infarction (HR 1.51, 95% CI 1.12 to 2.05), and heart failure hospital stay (HR 1.49, 95% CI 1.10 to 2.00). There was a trend toward higher cardiovascular mortality (p = 0.067) and coronary mortality (p = 0.051) in patients with MetSyn. In conclusion, MetSyn is associated with significant cardiovascular risk in older adults. The purpose of this study was to assess whether metabolic syndrome (MetSyn) predicts a higher risk for cardiovascular events in older adults. The importance of MetSyn as a risk factor has not previously focused on older adults and deserves further study. We studied the impact of MetSyn (38% prevalence) on outcomes in 3,035 participants in the Health, Aging, and Body Composition (Health ABC) study (51% women, 42% black, ages 70 to 79 years). During a 6-year follow-up, there were 434 deaths overall, 472 coronary events (CE), 213 myocardial infarctions (MI), and 231 heart failure (HF) hospital stays; 59% of the subjects had at least one hospital stay. Coronary events, MI, HF, and overall hospital stays occurred significantly more in subjects with MetSyn (19.9% vs. 12.9% for CE, 9.1% vs. 5.7% for MI, 10.0% vs. 6.1% for HF, and 63.1% vs. 56.1% for overall hospital stay; all p < 0.001). No significant differences in overall mortality was seen; however, there was a trend toward higher cardiovascular mortality (5.1% vs. 3.8%, p = 0.067) and coronary mortality (4.5% vs. 3.2%, p = 0.051) in patients with MetSyn. After adjusting for baseline characteristics, patients with MetSyn were at a significantly higher risk for CE (hazard ratio [HR] 1.56, 95% confidence interval [CI] 1.28 to 1.91), MI (HR 1.51, 95% CI 1.12 to 2.05), and HF hospital stay (HR 1.49, 95% CI 1.10 to 2.00). Women and whites with MetSyn had a higher cor