The impact of risk factor modification on asymptomatic atherosclerosis in patients with metabolic syndrome

Introduction Metabolic syndrome (MetS) is one of the main risk factors for atherosclerosis. Current research indicates the impact of its components to the progression of atherosclerosis and higher frequency of major cardiovascular (CV) events and mortality. The Aim Determining the components of MetS that correlate most with asymptomatic atherosclerosis (AA) and the effect its modification has on the progression of atherosclerosis. Material and Мethods The paper compares the results of 113 monitored patients with arterial hypertension in the period 2022-2023, divided into groups with and without MetS. In both groups the presence of subclinical carotid artery damage was assessed by measuring the thickness of tunica intima and media (IMT), the presence of plaques and stenosis, with analysis of the occurrence of major CV events from 2009 until the last control. Results After the last follow-up examination, the number of major CV events (40.70% vs. 11.86%) and cancer (22.00% vs. 6.77%) were significantly more frequent in the group of patients with MetS. Total mortality was higher but not statistically significant in the group with MetS. Lipid status and blood pressure were improved in both groups. After a 13-year follow-up, IMT increased (0.97 to 1.30 in patients with MetS and 0.85 to 0.99 in patients without MetS), along with the degree of stenosis in both groups (from 29.9% to 40.35% in the group with MetS and 37.80% to 42.40% without MetS). The group with MetS reached the target values in a smaller percentage for all components of MetS, especially triglycerides (45.7% in the group with MetS compared to 86% in the group without MetS). Conclusion Early identification of individuals with AA can prevent cardiac events in patients with MetS, but more intensive therapy and lifestyle changes are necessary to reach target values of its components and prevent progression to major CV events.