American Heart Journal
Volume 159, Issue 3 , Pages 385-391, March 2010

Variations in prevalent cardiovascular disease and future risk by metabolic syndrome classification in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study

  • Todd M. Brown, MD, MSPH

      Affiliations

    • Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, AL
    • Corresponding Author InformationReprint requests: Todd M. Brown MD, MSPH, UAB Division of Cardiovascular Diseases, LHRB 313, 701 19th Street South, Birmingham, AL 35294.
    • ,
  • Jenifer H. Voeks, PhD

      Affiliations

    • Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
    • ,
  • Vera Bittner, MD, MSPH

      Affiliations

    • Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, AL
    • ,
  • Monika M. Safford, MD

      Affiliations

    • Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL

Received 21 July 2009; accepted 26 December 2009.

Background

The International Diabetes Federation (IDF) and Adult Treatment Panel (ATP) III define metabolic syndrome (MetSyn) differently, with unclear implications for cardiovascular disease (CVD) risk.

Methods

We examined 22,719 participants in the REGARDS study. We classified participants as: no MetSyn, MetSyn by ATP-III and IDF criteria, MetSyn by ATP-only, or MetSyn by IDF-only. To assess current CVD, we determined the odds of self-reported CVD by MetSyn category using multivariable logistic regression, controlling for socio-demographic and behavioral factors. To estimate future coronary heart disease risk, we calculated Framingham risk scores (FRS).

Results

Overall, 10,785 individuals (47%) had MetSyn. Of these, 79% had MetSyn by both definitions, 6% by ATP-only, and 14% by IDF-only. Compared to those without MetSyn, ATP-only individuals had the highest odds of current CVD and of having a FRS >20%. Also compared to those without MetSyn, IDF-only individuals had 43% higher odds of current CVD and 2-fold increased odds of having a FRS >20%.

Conclusions

Consistent with previous reports, ATP-III MetSyn criteria identified individuals with increased odds of CVD and elevated future coronary heart disease risk. However, the IDF definition identified a clinically important number of additional individuals at excess CVD risk.

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PII: S0002-8703(10)00061-X

doi:10.1016/j.ahj.2009.12.022

American Heart Journal
Volume 159, Issue 3 , Pages 385-391, March 2010

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