Sundström J et al. (2006) Clinical value of the metabolic syndrome for long term prediction of total and cardiovascular mortality: prospective, population based cohort study. BMJ 332: 878–882

The metabolic syndrome is characterized by a grouping of metabolic risk factors in an individual, which can include obesity, high blood pressure, and glucose and lipid disturbances. A link between the metabolic syndrome and increased risk of cardiovascular disease (CVD) has been shown in several studies, and guidelines now include the syndrome as a risk factor for CVD. An article published in the BMJ adds to these data, listing the metabolic syndrome as a prognostic indicator of total and cardiovascular mortality.

Sundström and co-workers in Uppsala, Sweden, enrolled a large community-based group of 50-year-old men, to investigate whether the presence of the metabolic syndrome increased the risk of total and cardiovascular mortality when added to models of established risk factors for CVD (smoking, diabetes, hypertension and serum cholesterol). They used modified versions of the National Heart, Lung, and Blood Institute National Cholesterol Education Program (NCEP) and WHO definitions to define the metabolic syndrome.

At 50 years of age, presence or absence of the metabolic syndrome was predictive of total and cardiovascular mortality according to both definitions, although the NCEP definition was more strongly predictive; individuals with the metabolic syndrome had a 40–60% increased risk of total and cardiovascular mortality. At 70 years of age, however, the syndrome was not a reliable prognostic indicator. The authors advise that additional studies of a similar nature be done to confirm their findings.