Metabolic syndrome recovery reduces risk for CV events
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Patients who recovered from metabolic syndrome had decreased their risk for major adverse CV events, whereas those who developed metabolic syndrome had an increased risk for events, according to a study published in the Annals of Internal Medicine.
“Our results encourage those with prior metabolic syndrome to make effort to recover from the condition,” Sehoon Park, MD, research fellow at of Seoul National University Hospital in South Korea, told Healio. “In addition, even those free from metabolic syndrome, efforts to prevent the development of metabolic syndrome may be considered. Furthermore, considering the size of our cohort, a nationwide, policy-based intervention or campaign may be considered to reduce the socioeconomic burden of cardiovascular diseases, which is the leading cause of death worldwide.”
Patient screening data
Researchers analyzed data from 9,553,042 patients from the National Health Insurance Database of Korea aged 20 years and older who were screened from 2009 to 2014 and were free from a history of major adverse CV events. Several baseline characteristics were assessed at the third screening such as sex, age, BMI, systolic and diastolic BP, and total cholesterol.
Metabolic syndrome was defined as the presence of three or more of the following components: elevated triglyceride level or use of a relevant drug, increased waist circumference, elevated BP or use of an antihypertensive medication, reduced HDL or use of a relevant drug and elevated fasting glucose level or the use of an antidiabetic drug.
Patients were categorized based on metabolic syndrome status:
- metabolic syndrome free (n = 6,940,663; mean age, 45 years; 54% men), defined as the absence of metabolic syndrome during the first three health examinations;
- metabolic syndrome chronic (n = 1,486,485; mean age, 58 years; 51% men), in which the syndrome was present throughout all three examinations;
- metabolic syndrome developed (n = 587,088; mean age, 55 years; 56% men), defined as those who developed the syndrome at the second and third visit; and
- metabolic syndrome recovery (n = 538,806; mean age, 52 years; 63% men), in which patients had the syndrome at the first visit but not at the second and third visits.
The outcome of interest was major adverse CV events, defined as revascularization, acute MI and acute ischemic stroke. Patients were followed up as of 1 day after the third examination until death or Dec. 31, 2016, whichever occurred first for a median of 3.54 years.
During follow-up, patients in the metabolic syndrome recovery group had a lower risk for major adverse CV events (incidence rate, 4.55 per 1,000 person-years) compared with those in the metabolic syndrome chronic group (incidence rate, 8.52 per 1,000 person-years).
Patients who developed metabolic syndrome during the study had a higher risk for major adverse CV events (incidence rate, 6.05 per 1,000 person-years) vs. those who were free from the syndrome (incidence rate, 1.92 per 1,000 person-years; adjusted incidence rate ratio = 1.36; 95% CI, 1.33-1.39).
The largest difference in the risk for major adverse CV events was seen when a patient developed hypertension.
Additional research
“Further research may focus on population-scale lifestyle modification strategy (eg, encouraging exercise, quitting smoking) that can actually prevent or facilitate recovery from metabolic syndrome,” Park said in an interview. “Such policy or intervention may significantly reduce the critical burden of cardiovascular diseases.” – by Darlene Dobkowski
For more information:
Sehoon Park, MD, can be reached at mailofsehoon@gmail.com.
Disclosures: Park reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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