Global Coronary Heart Disease Risk Assessment of U.S. Persons With the Metabolic Syndrome

Abstract

Objective: While metabolic syndrome (MetS) is related to an increased risk of coronary heart disease (CHD) events, persons with MetS encompass a wide range of CHD risk levels. This study describes the distribution of 10-year CHD risk among U.S. adults with MetS.

Research Design and Methods: MetS was defined by the modified National Cholesterol Education Program/Adult Treatment Panel (NCEP/ATP III) definition among 4293 U.S. adults aged 20-79 in the U.S. National Health and Nutrition Examination Survey 2003-2004. Low, moderate, moderately high, and high risk status were defined as <6%, 6-10%, 10-20%, and >20% probability of CHD in 10 years (based on NCEP/ATP III Framingham risk score algorithms), respectively; those with diabetes or pre-existing cardiovascular disease were assigned to high risk status.

Results: The weighted prevalence of MetS by NCEP criteria in our study was 29.0% overall (30.0% in men (M) and 27.9% in women (F), p=0.28). 38.5% (M: 30.7%, F: 46.9%) were classified as low risk, 8.5% (M: 7.9%, F: 9.1%) moderate risk, 15.8% (M: 23.4%, F: 7.6%) moderately high risk, and 37.3% (M: 38.0%, F: 36.5%) high risk. The proportion at high risk increased with age but was similar between Hispanics, non-Hispanic whites, and non-Hispanic blacks.

Conclusions: While many MetS subjects are at low calculated risk for CHD, about half are at moderately high or high risk, reinforcing the need for global risk assessment in persons with MetS to appropriately target intensity of treatment for underlying CHD risk factors.