The Metabolic Syndrome and Cardiovascular Risk
Open accessAbstract
Objectives We sought to conduct a systematic review and meta-analysis of the cardiovascular risk associated with the metabolic syndrome as defined by the 2001 National Cholesterol Education Program (NCEP) and 2004 revised National Cholesterol Education Program (rNCEP) definitions.Background Numerous studies have investigated the cardiovascular risk associated with the NCEP and rNCEP definitions of the metabolic syndrome. There is debate regarding the prognostic significance of the metabolic syndrome for cardiovascular outcomes.Methods We searched the Cochrane Library, EMBASE, and Medline databases through June 2009 for prospective observational studies investigating the cardiovascular effects of the metabolic syndrome. Two reviewers extracted data, which were aggregated using random-effects models.Results We identified 87 studies, which included 951,083 patients (NCEP: 63 studies, 497,651 patients; rNCEP: 33 studies, 453,432 patients). There was little variation between the cardiovascular risk associated with NCEP and rNCEP definitions. When both definitions were pooled, the metabolic syndrome was associated with an increased risk of cardiovascular disease (CVD) (relative risk [RR]: 2.35; 95% confidence interval [CI]: 2.02 to 2.73), CVD mortality (RR: 2.40; 95% CI: 1.87 to 3.08), all-cause mortality (RR: 1.58; 95% CI: 1.39 to 1.78), myocardial infarction (RR: 1.99; 95% CI: 1.61 to 2.46), and stroke (RR: 2.27; 95% CI: 1.80 to 2.85). Patients with the metabolic syndrome, but without diabetes, maintained a high cardiovascular risk.Conclusions The metabolic syndrome is associated with a 2-fold increase in cardiovascular outcomes and a 1.5-fold increase in all-cause mortality. Studies are needed to investigate whether or not the prognostic significance of the metabolic syndrome exceeds the risk associated with the sum of its individual components. Furthermore, studies are needed to elucidate the mechanisms by which the metabolic syndrome increases cardiovascular risk.
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People with MetS have a 2-fold increase in CV outcomes and a 1.5-fold increase in all-cause mortality.
“Data from recent meta-analyses indicate that people with MetS have a 2-fold increase in CV outcomes and 1.5-fold increase in all-cause mortality.168”
From ESC/EAS Guidelines for the management of dyslipidaemias (2011) · cites this paper as [168]
Recent meta-analyses indicate people with MetS have a two-fold increase in CV outcomes and a 1.5-fold increase in all-cause mortality.
“Data from recent meta-analyses indicate that people with MetS have a two-fold increase in CV outcomes and a 1.5-fold increase in all-cause mortality. 348”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [348]
Metabolic syndrome identifies people at higher risk of CVD than the general population.
“MetS identifies people at a higher risk of CVD than the general population.”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [348]
Data from recent meta-analyses indicate that people with metabolic syndrome have a two-fold increase in cardiovascular outcomes and a 1.5-fold increase in all-cause mortality.
“Data from recent meta-analyses indicate that people with MetS have a two-fold increase in CV outcomes and a 1.5fold increase in all-cause mortality.348”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [348]
Metabolic syndrome is a condition that poses a high risk for the development of cardiovascular disease.
“[Statement]Metabolic syndrome is a condition that poses a high risk for the development of cardiovascular disease (Evidence level: E-1b).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [326]
Conditions such as metabolic syndrome that involve the clustering of multiple risk factors have been shown to increase the risk of cardiovascular diseases in epidemiological studies and meta-analyses, as well as in CIRCS study, Tanno and Sobetsu study, and Hisayama study.
“Conditions, such as metabolic syndrome, that involve the clustering of multiple risk factors have been shown to increase the risk of cardiovascular diseases in epidemiological studies323–326) and meta-analyses327), as well as in CIRCS study78), the Tanno and Sobetsu study328) and the Hisayama study317).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [326]
Metabolic syndrome is significant because it is a high risk of ASCVD even if the levels of hyperglycemia, dyslipidemia and elevated blood pressure are relatively mild.
“Metabolic syndrome is significant because it is a high risk of ASCVD even if the levels of hyperglycemia, dyslipidemia and elevated blood pressure are relatively mild323–327).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [326]
MetS is associated with a >2-fold increased risk for ASCVD and cardiovascular mortality, based on a meta-analysis of 87 studies with 951,083 patients.
“A meta-analysis, including 87 studies with 951,083 patients, demonstrated that MetS was associated with a >2-fold increased risk for ASCVD and cardiovascular mortality (9).”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [9]
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- Authors
- Mottillo, S., Filion, K. B., Genest, J., Joseph, L., Pilote, L., Poirier, P., Rinfret, S., Schiffrin, E. L., & Eisenberg, M. J.
- Affiliations
- Jewish General Hospital (CA)
- McGill University Health Centre (CA)
- Institut universitaire de cardiologie et de pneumologie de Québec (CA)
- Corresponding author
- Eisenberg, Mark J.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2010-09
- Volume
- 56
- Issue
- 14
- Pages
- 1113-1132
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2129448542
- Cited by
- 3,009
- References
- 118
- Citations by year
- 2026: 168 · 2025: 198 · 2024: 235 · 2023: 255 · 2022: 219 · 2021: 201 · 2020: 225 · 2019: 197 · 2018: 178 · 2017: 138 · 2016: 182 · 2015: 179 · 2014: 181 · 2013: 189 · 2012: 155
- FWCI
- 108.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (82918)
- CIHR Team Grant in Cardiovascular Outcomes Research
- 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 › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- metabolic syndrome, cardiovascular risk, cardiovascular mortality, myocardial infarction, stroke, all-cause mortality, NCEP criteria, diabetes mellitus, prognostic value
- MeSH terms
- Cardiovascular Diseases, Cause of Death, Coronary Disease, Female, Humans, Male, Severity of Illness Index, Comorbidity, Prevalence, Survival Analysis, Risk Assessment, Stroke, Metabolic Syndrome
About these checks
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