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October 14, 2008Diabetes CareOpen Access

Blood Pressure and Fasting Plasma Glucose Rather Than Metabolic Syndrome Predict Coronary Artery Calcium Progression

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Key result

In older adults without known heart disease, hypertension independently predicted coronary artery calcium progression (OR 2.11), whereas metabolic syndrome itself did not.

Why the study?

Does metabolic syndrome or its individual components predict coronary artery calcium progression in older adults without known heart disease?

Population

338 older community-dwelling men and women without known heart disease, mean age 67.6 years.

Comparison

Metabolic syndrome and its components vs Absence of metabolic syndrome or its components

Design

Cohort

Follow-up

average 4.5 years

Authors

CKCaroline K. KramerDMDenise von MühlenJGJorge Luiz Gross

Discussion

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Member takes

Overview

Hypertension may inform CAC monitoring in older adults without heart disease; leaves open whether metabolic syndrome adds value beyond its components.

Study Design

Type

Cohort (n=338)

Multicenter

No

Structured PICO

Does metabolic syndrome or its individual components predict coronary artery calcium progression in older adults without known heart disease?

P
Population
338 older community-dwelling adults without known heart disease were followed for an average of 4.5 years to assess predictors of coronary artery calcium progression.
E
Exposure
Metabolic syndrome (WHO and ATP-III criteria) and its components (blood pressure, fasting plasma glucose)
C
Comparator
Absence of metabolic syndrome or its components
O
Outcome
Coronary artery calcium (CAC) progression (increase in total CAC volume score >= 2.5 mm3) at an average interval of 4.5 yearssurrogate

Main Result

Odds Ratio: 2.11 (95% CI 1.33–3.3)

p-value: p=0.002

Individual risk factors like hypertension and fasting plasma glucose are better predictors of coronary artery calcium progression than the composite metabolic syndrome in older adults.

Limitations

  • Exclusion of individuals with known CHD may have reduced associations by excluding those with more risk factors.
  • The cohort consisted of middle- to upper-middle-class Caucasian adults, which may limit generalizability to other populations.
  • Relatively small sample size compared to other large observational studies like MESA.

Cite This Study

Kramer et al. (2008) conducted a cohort in Coronary Artery Calcium Progression (n=338). Metabolic syndrome and its components (hypertension, fasting plasma glucose) vs. Absence of metabolic syndrome or its components was evaluated on Coronary artery calcium (CAC) progression (increase in total CAC volume score ≥2.5 mm3) (OR 2.11, 95% CI 1.33-3.3, p=0.002). In older adults without known heart disease, hypertension independently predicted coronary artery calcium progression (OR 2.11), whereas metabolic syndrome itself did not.

synapsesocial.com/papers/6aa3e440fd19ae9969b152e5https://doi.org/10.2337/dc08-1360
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1World Health Organization-Defined Metabolic Syndrome Is a Better Predictor of Coronary Calcium Than the Adult Treatment Panel III Criteria in American Men Aged 40–49 Years2004 · 42 citations
  2. 2Progression of Coronary Artery Calcium and Occurrence of Myocardial Infarction in Patients With and Without Diabetes Mellitus2005 · 118 citations
  3. 3Prevalence of the Metabolic Syndrome Among US Adults2002 · 6,723 citations
  4. 4Electron-Beam Tomography Coronary Artery Calcium and Cardiac Events2003 · 736 citations
  5. 5<b>Evaluating Changes in Coronary Artery Calcium:</b> An Analytic Method That Accounts for Interscan Variability2004 · 208 citations