Asymptomatic metabolic syndrome at midlife confers CV event, mortality risk later on
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Key takeaways:
- Asymptomatic metabolic syndrome in middle age may increase risk for CV events and mortality.
- Time to first nonfatal CV event was 2.3 years earlier among those with metabolic syndrome vs. controls.
Asymptomatic metabolic syndrome at midlife was associated with increased risk and earlier occurrence of CV events and mortality later in life, researchers reported.
Traits that comprised asymptomatic metabolic syndrome included elevated waist circumference, cholesterol, BP and fasting glucose, according to a study presented at the European Society of Cardiology Congress.
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“The global prevalence varies from 12.5% to 31.4% when the definition from NCEP-ATP III was used. The prevalence of asymptomatic metabolic syndrome was significantly higher in the Eastern Mediterranean Region and Americas and increased with a country’s level of income,” Lena Lönnberg, PhD, physiotherapist at Västmanland County Hospital in Västerås, Sweden, and the Uppsala Clinical Research Center in Sweden, told Healio. “The metabolic syndrome is a serious condition. The results underline that early detection, eg, with health screening programs focused on CV risk factors, is of major importance to detect raised levels of the risk factors involved in the metabolic syndrome to avoid both premature death and CV events.”
To better understand the impact of asymptomatic metabolic syndrome during midlife on risk for CV events and premature death later on, residents of Västmanland County aged 40 or 50 years were invited to a health screening from 1990 to 1999.
The screenings included blood sampling for CV risk factors, anthropometric measurements and a questionnaire of lifestyle habits and socioeconomic factors.
Asymptomatic metabolic syndrome was defined by having three or more of the following risk factors: waist circumference of 102 cm or more for men and 88 cm or more for women; total cholesterol 6.1 mmol/L or more; BP of 130/85 mm Hg or more or a previous diagnosis of hypertension; and fasting plasma glucose of 5.6 mmol/L or more or a previous diagnosis of type 2 diabetes.
Overall, 5,084 residents were diagnosed with asymptomatic metabolic syndrome and were individually matched by age, sex and screening date to a control cohort.
During approximately 27 years of follow-up, the mortality rate among patients with asymptomatic metabolic syndrome was 10 per 1,000 person years compared with seven per 1,000 person years among the control arm.
Lönnberg and colleagues reported that the median time to first nonfatal CV event was 2.3 years earlier (19.1 years vs. 16.8 years) among those with asymptomatic metabolic syndrome compared with controls.
“As metabolic syndrome is a cluster of risk factors, the level of each individual component does not have to be severely raised. In fact, most people live with slightly raised levels for many years before having symptoms that lead them to seek health care,” Lönnberg said in a press release. “In our study, middle-aged adults with metabolic syndrome had a heart attack or stroke 2.3 years earlier than those without the collection of unhealthy traits. Blood pressure was the riskiest component, particularly for women in their 40s, highlighting the value of keeping it under control.”
After adjusting for age, sex, BMI, hip circumference, smoking, living alone, physical activity and educational attainment, asymptomatic metabolic syndrome at midlife was associated with a nearly 40% greater risk for nonfatal CV events (HR = 1.39; 95% CI, 1.3-1.5; P .001) and a 34% greater risk for all-cause mortality (HR = 1.34; 95% CI, 1.23-1.45; P < .001) compared with no metabolic syndrome.
“Our findings illuminate the importance of reaching the BP target goal when the BP is high. In addition, lifestyle counseling to support healthy lifestyle choices are important tools to reduce the harmful impact from asymptomatic metabolic syndrome on both all-cause mortality and CV morbidity,” Lönnberg told Healio.
Reference:
- Cluster of slightly unhealthy traits linked with earlier heart attack and stroke. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Cluster-of-slightly-unhealthy-traits-linked-with-earlier-heart-attack-and-stroke. Published Aug. 25, 2023. Accessed Aug. 25, 2023.
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Lönnberg L, et al. Abstract 82848. Presented at: European Society of Cardiology Congress; Aug. 25-28, 2023; Amsterdam (hybrid meeting).
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