Costs of the Metabolic Syndrome in Elderly Individuals
Findings from the Cardiovascular Health Study*
- Lesley H. Curtis, PHD12,
- Bradley G. Hammill, MS1,
- M. Angelyn Bethel, MD2,
- Kevin J. Anstrom, PHD34,
- John S. Gottdiener, MD5 and
- Kevin A. Schulman, MD12
- 1Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina
- 2Department of Medicine, Duke University School of Medicine, Durham, North Carolina
- 3Outcomes Research and Assessment Group, Duke Clinical Research Institute, Durham, North Carolina
- 4Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina
- 5Division 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
Abstract
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.
- ATP III, Adult Treatment Panel III
- CHS, Cardiovascular Health Study
- IDF, International Diabetes Federation
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 10 July 2007. DOI: 10.2337/dc07-0460.
L.H.C. and K.A.S. have received research support from sanofi-aventis; a complete detailed list of duality of interest disclosures can be found at http://www.dcri.duke.edu/research/coi.jsp. M.A.B. has received research support and honoraria for speaker’s bureau membership from sanofi-aventis.
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↵* A complete list of participating CHS investigators and institutions is available at http://www.chs-nhlbi.org.
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted June 28, 2007.
- Received March 7, 2007.
- DIABETES CARE
