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Costs of the Metabolic Syndrome in Elderly Individuals

Findings from the Cardiovascular Health Study^*

¹ Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina
² Department of Medicine, Duke University School of Medicine, Durham, North Carolina
³ Outcomes Research and Assessment Group, Duke Clinical Research Institute, Durham, North Carolina
⁴ Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina
⁵ Division of Cardiology, University of Maryland School of Medicine, Baltimore, Maryland

Address correspondence and reprint requests to Lesley H. Curtis, PhD, Center for Clinical and Genetic Economics, Duke Clinical Research Institute, P.O. Box 17969, Durham, NC 27715. E-mail: lesley.curtis{at}duke.edu

OBJECTIVE—The cardiovascular consequences of the metabolic syndrome and its component risk factors have been documented in elderly individuals. Little is known about how the metabolic syndrome and its individual components translate into long-term medical costs.

RESEARCH DESIGN AND METHODS—We used log-linear regression models to assess the independent contributions of the metabolic syndrome and its individual components to 10-year medical costs among 3,789 individuals aged 65 years in the Cardiovascular Health Study.

RESULTS—As defined by the National Cholesterol Education Program Third Adult Treatment Panel report, the metabolic syndrome was present in 47% of the sample. Total costs to Medicare were 20% higher among participants with the metabolic syndrome ($40,873 vs. $33,010; P < 0.001). Controlling for age, sex, race/ethnicity, and other covariates, we found that abdominal obesity, low HDL cholesterol, and elevated blood pressure were associated with 15% (95% CI 4.3–26.7), 16% (1.7–31.8), and 20% (10.1–31.7) higher costs, respectively. When added to the model, the metabolic syndrome composite variable did not contribute significantly (P = 0.32).

CONCLUSIONS—Abdominal obesity, low HDL cholesterol, and hypertension but not the metabolic syndrome per se are important predictors of long-term costs in the Medicare population.

Abbreviations: ATP III, Adult Treatment Panel III • CHS, Cardiovascular Health Study • IDF, International Diabetes Federation

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