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Distinct Component Profiles and High Risk Among African Americans With Metabolic Syndrome

The Jackson Heart Study

From the Jackson Heart Study, Jackson State University, University of Mississippi Medical Center, Jackson, Mississippi

Corresponding author: Herman A. Taylor, MD, MPH, Jackson Heart Study, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216-4505. E-mail: htaylor{at}medicine.umsmed.edu

OBJECTIVE—Health of African Americans is seriously threatened by unremitting epidemics of diabetes and cardiovascular disease (CVD). However, the role of metabolic syndrome in the African-American population has not been investigated widely. This study examined the prevalence of metabolic syndrome and assessed its cross-sectional relationship to CVD in the Jackson Heart Study (JHS) cohort.

RESEARCH DESIGN AND METHODS—A total of 5,302 participants aged 21 years who were recruited at baseline during 2000–2004 were analyzed for this study. Adjusted odds ratios (ORs) were estimated in a logistic regression analysis for coronary heart disease (CHD) and cerebrovascular disease (CBD) in those with and without coexisting metabolic syndrome. Diabetic participants were excluded.

RESULTS—Among those aged 35–84 years, metabolic syndrome prevalence was 43.3% in women and 32.7% in men. Elevated blood pressure (70.4%), abdominal obesity (64.6%), and low HDL cholesterol (37.2%) were highly prevalent among those with metabolic syndrome. Prevalence rates for CVD, CHD, and CBD were 12.8, 8.7, and 5.8%, respectively. After adjustment for age and sex, metabolic syndrome was associated with increased age- and sex-adjusted ORs for CVD (OR 1.7 [95% CI 1.4–2.1]), CHD (1.7 [1.4–2.2]), and CBD (1.7 [1.3–2.3]) compared with those without CVD, CHD, or CBD.

CONCLUSION—Metabolic syndrome prevalence in the JHS is among the highest reported for population-based cohorts worldwide and is significantly associated with increased ORs for CVD, CHD, and CBD. Abdominal obesity, increased blood pressure, and low HDL cholesterol (without triglyceride elevation) are surprisingly prominent. A high prevalence of low HDL emerges as a leading contributor to metabolic syndrome among African Americans in this large African-American cohort.

Abbreviations: ATP III, Third Adult Treatment Panel Report • CBD, cerebrovascular disease • CHD, coronary heart disease • CVD, cardiovascular disease • ECG, electrocardiogram • JHS, Jackson Heart Study • NCEP, National Cholesterol Education Program • NHANES, National Health and Nutrition Examination Survey

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