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Costs of the Metabolic Syndrome in the Elderly: Findings From the Cardiovascular Health Study

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

lesley.curtis{at}duke.edu

ABSTRACT

Objective:The cardiovascular consequences of the metabolic syndrome and its component risk factors have been documented in the elderly. 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 3789 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 < .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% confidence interval [CI], 4.3-26.7), 16% (95% CI, 1.7-31.8), and 20% (95% CI, 10.1-31.7) higher costs, respectively. When added to the model, the metabolic syndrome composite variable did not contribute significantly (P = .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.

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