Copyright © 2004 by the European Society of Cardiology.
Clinical research
The Metabolic Syndrome is associated with advanced vascular damage in patients with coronary heart disease, stroke, peripheral arterial disease or abdominal aortic aneurysm
a Internal Medicine, Section of Vascular Medicine, UMC Utrecht, Utrecht, The Netherlands
b Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands
c Department of Neurology, UMC Utrecht, Utrecht, The Netherlands
* Corresponding Author: J. K. Olijhoek, MD, Internal Medicine, Section of Vascular Medicine, UMC Utrecht, G02.402, Heidelberglaan 100; 3584 CX Utrecht, The Netherlands. Tel.: +31-30-2509111; Fax: +31-30-2518328
E-mail address: J.K.Olijhoek{at}azu.nl
Received 1 July 2003; revised 24 November 2003; accepted 4 December 2003
Abstract
Aims The metabolic syndrome is associated with an increased risk of cardiovascular disease in patients without a cardiovascular history. We investigated whether the metabolic syndrome is related to the extent of vascular damage in patients with various manifestations of vascular disease.
Methods and results The study population of this cross-sectional survey consisted of 502 patients recently diagnosed with coronary heart disease (CHD), 236 with stroke, 218 with peripheral arterial disease (PAD) and 89 with abdominal aortic aneurysm (AAA). Metabolic syndrome was diagnosed according to Adult Treatment Panel III criteria. Carotid Intima Media Thickness (IMT), Ankle Brachial Pressure Index (ABPI) and albuminuria were used as non-invasive markers of vascular damage and adjusted for age and sex if appropriate.
The prevalence of the metabolic syndrome in the study population was 45%. In PAD patients this was 57%; in CHD patients 40%, in stroke patients 43% and in AAA patients 45%. Patients with the metabolic syndrome had an increased mean IMT (0.98 vs 0.92mm, P-value <0.01), more often a decreased ABPI (14% vs 10%, P-value 0.06) and increased prevalence of albuminuria (20% vs 15%, P-value 0.03) compared to patients without this syndrome. An increase in the number of components of the metabolic syndrome was associated with an increase in mean IMT (P-value for trend <0.001), lower ABPI (P-value for trend <0.01) and higher prevalence albuminuria (P-value for trend <0.01).
Conclusion In patients with manifest vascular disease the presence of the metabolic syndrome is associated with advanced vascular damage.
Key Words: Metabolic Syndrome • Atherosclerosis • Coronary heart disease • Stroke • Peripheral arterial disease • Abdominal aortic aneurysm
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