The Effect of Metabolic Syndrome and its Components on Long Term Outcome in Patients with Cardiovascular Disease in Bangladesh

Background: The "Metabolic Syndrome" (MetS), a clustering of risk factors including abdominal obesity, poor glucose tolerance, hypertriglyceridemia, decreased high density lipoprotein (HDL) cholesterol, and/or hypertension. Cardiovascular disease (CVD) is the cause of 46.2% of non-communicable disease mortality, attracting attention on a global scale. One of the key reasons for early mortality and disability is CVD. According to the National Health and Nutritional Examination Survey (NHANES), approximately 30% of overweight and 60% of obese men and women are diagnosed with MetS. People with CVD have a greater rate of MetS than patients without the condition. Objective: The aim of the study is to assess the effect of Metabolic Syndrome and its components on long term outcome in patients with cardiovascular disease in Bangladesh. Methods: The study consisted of 415 persons who were aged between 35-84 years, during June 2020–May 2022. Data were collected through interview, clinical examination, and laboratory tests, and their survival status until April 2022 was ascertained. We defined MetS following the NCEP ATP III criteria, with minor modifications, i.e., presence of any three of the following: hypertension (BP ≥130/85 mm Hg); random blood glucose (RBG) level ≥7.0 mmol/L; hyper-triglyceridemia (≥2.28 mmol/L); low level of HDL-cholesterol (<1.04 mmol/L for men and <1.29 mmol/L for women); and BMI ≥25.0 kg/m2. Data were analysed with logistic regressions for the influential factors of MetS, and with Cox models for the association of MetS with the survival status. Results: MetSwas found in 137 (33.1%) participants and were older (57.9 ± 13.0) and primarily male (60.6%).Participants with MetS showed a greater prevalence of diabetes, hypertension, hypercholesterolemia, and overall worse management of risk variables at baseline, as predicted. The most common feature across all patients was raised fasting blood glucose (93.4%), followed by blood pressure (91.2%), ......