Metabolic syndrome as major determinant of ischaemic cardiovascular disease among middle-aged Japanese subjects
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This 18-year prospective study of 9087 subjects, free of ischaemic heart disease or stroke at baseline and aged 40 to 69 years, was conducted to investigate the association of the metabolic syndrome and the risk of ischaemic cardiovascular disease in a Japanese study population, the metabolic syndrome being defined by the modified NCEP ATP III criteria with BMI ≥25.0 kg/m2 instead of increased waist circumference. After adjusting for cardiovascular risk factors, high blood pressure, high triglycerides and low HDL-cholesterol were associated with increased risk of ischaemic heart disease or stroke in both sexes. The incidence of cardiovascular end points increased with the number of metabolic risk factors. The multivariable hazard ratio associated with the metabolic syndrome was 2.4 for ischaemic heart disease and 2.0 for ischaemic stroke in men, and 2.3 and 1.5 in women, respectively, irrespective of total cholesterol. Based on these data, the authors conclude that the metabolic syndrome is a major determinant of ischaemic cardiovascular disease in middle-aged Japanese subjects.
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