What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Metabolic Syndrome and Carotid Arteriosclerosis (n=8144). Intervention: Hypertension vs. Absence of hypertension. Primary outcome: Carotid plaque (OR 1.43, 95% CI 1.27-1.60).

January 1, 2005Open Access

Hypertension Is the Most Common Component of Metabolic Syndrome and the Greatest Contributor to Carotid Arteriosclerosis in Apparently Healthy Japanese Individuals

Resultado clave

Hypertension was the most common component of metabolic syndrome and the strongest independent risk factor for carotid plaque, increasing the odds by 43% (OR 1.43).

Diseño del estudio

Tipo

Cross-Sectional (n=8,144)

Multicéntrico

PICO estructurado

Población

8,144 apparently healthy Japanese adults aged 19-88 years undergoing general health screening were evaluated cross-sectionally for metabolic syndrome and carotid arteriosclerosis.

Resultado

Presence of carotid plaque (defined as clearly isolated focal thickening of the intima-media layer with a thickness of ≥1.3 mm)surrogate

Hypertension is the most common component of metabolic syndrome and the strongest independent risk factor for carotid plaque among metabolic risk factors in healthy Japanese individuals.

Resultado numérico

Odds Ratio: 1.43 (95% CI 1.27–1.6)

Limitaciones

Potential selection bias in terms of the subjects who undergo health checkups
Individuals with previous cerebrovascular events are less likely to undergo general health screening, potentially underestimating prevalence
Cross-sectional nature prevents longitudinal observations to address the relationship between metabolic syndrome risk factors and carotid arteriosclerosis

Resumen

The cluster of metabolic and hemodynamic risk factors known as metabolic syndrome is known to be a risk factor for ischemic cardiovascular diseases and stroke. By analyzing the cross-sectional data from 8,144 individuals (age 19-88 years) who underwent general health screening, we have investigated the prevalence of metabolic syndrome, as diagnosed by modified-National Cholesterol Education Program (NCEP) criteria corresponding to the following five categories: triglycerides > or = 150 mg/dl; high density lipoprotein (HDL)-cholesterol or = 110 mg/dl; systolic/diastolic blood pressure > or = 130/85 mmHg; and body mass index > 25 kg/m2. We found that the prevalence of metabolic syndrome was 19% in men and 7% in women. After adjustment for age, metabolic syndrome was found to be significantly more prevalent in men than in women, with an odds ratio of 3.08 (95% confidence interval CI 2.62-3.61, p < 0.0001). Among the five metabolic/hemodynamic risk factor components, hypertension was observed most frequently in individuals with metabolic syndrome, at 85% in men and 87% in women. In addition, multivariate logistic regression analysis adjusted for age, sex, serum total cholesterol levels, and smoking status showed that hypertension possessed the greatest odds ratio (1.43, 95% CI 1.27-1.60) for carotid plaque among the metabolic/hemodynamic risk factors. These data emphasize the importance of controlling blood pressure for reducing the risk of both metabolic syndrome and carotid arteriosclerosis in apparently healthy individuals.

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