Cited by 1,888Diabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Health and Risk FactorsCardiovascular Function and Risk Factors

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Metabolic Syndrome and Risk of Incident Cardiovascular Events and Death

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Gami, Apoor S., Witt, Brandi J., Howard, Daniel E., Erwin, Patricia J., Gami, Lisa A., Somers, Virend K., Montori, Victor M.·2007·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2006.09.032

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Abstract

Objectives The purpose of this research was to assess the association between the metabolic syndrome (MetSyn) and cardiovascular events and mortality by meta-analyses of longitudinal studies.Background Controversy exists regarding the cardiovascular risk associated with MetSyn.Methods We searched electronic reference databases through March 2005, studies that referenced Reaven's seminal article, abstracts presented at meetings in 2003 to 2004, and queried experts. Two reviewers independently assessed eligibility. Longitudinal studies reporting associations between MetSyn and cardiovascular events or mortality were eligible. Two reviewers independently used a standardized form to collect data from published reports. Authors were contacted. Study quality was assessed by the control of selection, detection, and attrition biases.Results We found 37 eligible studies that included 43 cohorts (inception 1971 to 1997) and 172,573 individuals. Random effects meta-analyses showed MetSyn had a relative risk (RR) of cardiovascular events and death of 1.78 (95% confidence interval [CI] 1.58 to 2.00). The association was stronger in women (RR 2.63 vs. 1.98, p = 0.09), in studies enrolling lower risk (<10%) individuals (RR 1.96 vs. 1.43, p = 0.04), and in studies using factor analysis or the World Health Organization definition (RR 2.68 and 2.06 vs. 1.67 for National Cholesterol Education Program definition and 1.35 for other definitions; p = 0.005). The association remained after adjusting for traditional cardiovascular risk factors (RR 1.54, 95% CI 1.32 to 1.79).Conclusions The best available evidence suggests that people with MetSyn are at increased risk of cardiovascular events. These results can help clinicians counsel patients to consider lifestyle interventions, and should fuel research of other preventive interventions.

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Authors: Gami, A. S., Witt, B. J., Howard, D. E., Erwin, P. J., Gami, L. A., Somers, V. K., & Montori, V. M.
Affiliations: Mayo Clinic (US)
Corresponding author: Gami, Apoor S.
ORCID: Somers, Virend K.
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2007-01
Volume: 49
Issue: 4
Pages: 403-414
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2006.09.032
OpenAlex: W74340591
Cited by: 1,888
References: 67
Citations by year: 2026: 31 · 2025: 38 · 2024: 70 · 2023: 58 · 2022: 76 · 2021: 91 · 2020: 87 · 2019: 99 · 2018: 103 · 2017: 84 · 2016: 113 · 2015: 125 · 2014: 131 · 2013: 140 · 2012: 122
FWCI: 91.62
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 2388 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
Funders: World Health Organization
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords: metabolic syndrome, cardiovascular events, cardiovascular mortality, cardiovascular risk, sex differences, metabolic syndrome definitions, traditional cardiovascular risk factors, lifestyle intervention
MeSH terms: Cardiovascular Diseases, Humans, Longitudinal Studies, Risk Factors, Metabolic Syndrome

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