Cited by 2,292Adipokines, Inflammation, and Metabolic DiseasesLipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and Lipoproteins

C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events: An 8-Year Follow-Up of 14 719 Initially Healthy American Women

Ridker, Paul M, Buring, Julie E., Cook, Nancy R., Rifai, Nader·2003·Circulation

Abstract

Background— The metabolic syndrome describes a high-risk population having 3 or more of the following clinical characteristics: upper-body obesity, hypertriglyceridemia, low HDL, hypertension, and abnormal glucose. All of these attributes, however, are associated with increased levels of C-reactive protein (CRP). Methods and Results— We evaluated interrelationships between CRP, the metabolic syndrome, and incident cardiovascular events among 14 719 apparently healthy women who were followed up for an 8-year period for myocardial infarction, stroke, coronary revascularization, or cardiovascular death; 24% of the cohort had the metabolic syndrome at study entry. At baseline, median CRP levels for those with 0, 1, 2, 3, 4, or 5 characteristics of the metabolic syndrome were 0.68, 1.09, 1.93, 3.01, 3.88, and 5.75 mg/L, respectively ( P trend <0.0001). Over the 8-year follow-up, cardiovascular event-free survival rates based on CRP levels above or below 3.0 mg/L were similar to survival rates based on having 3 or more characteristics of the metabolic syndrome. At all levels of severity of the metabolic syndrome, however, CRP added prognostic information on subsequent risk. For example, among those with the metabolic syndrome at study entry, age-adjusted incidence rates of future cardiovascular events were 3.4 and 5.9 per 1000 person-years of exposure for those with baseline CRP levels less than or greater than 3.0 mg/L, respectively. Additive effects for CRP were also observed for those with 4 or 5 characteristics of the metabolic syndrome. The use of different definitions of the metabolic syndrome had minimal impact on these findings. Conclusions— These prospective data suggest that measurement of CRP adds clinically important prognostic information to the metabolic syndrome.

Integrity signals

Registry

Crossref · 10.1161/01.cir.0000055014.62083.05

Cites

30 of 30 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Ridker, P. M., Buring, J. E., Cook, N. R., & Rifai, N.
Affiliations
Brigham and Women's Hospital (US)
Venue
Circulation
Published
2003-01-28
Volume
107
Issue
3
Pages
391-397
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2142179136
Cited by
2,292
References
30
Citations by year
2026: 27 · 2025: 24 · 2024: 37 · 2023: 35 · 2022: 40 · 2021: 62 · 2020: 38 · 2019: 43 · 2018: 63 · 2017: 64 · 2016: 58 · 2015: 94 · 2014: 98 · 2013: 86 · 2012: 114
FWCI
142.89
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01hl043851-10)
  • National Heart, Lung, and Blood Institute (R01HL058755, HL43851, HL 63293, HL-58755, R01HL063293)
Topics
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
C-reactive protein, metabolic syndrome, cardiovascular events, cardiovascular risk prediction, women, myocardial infarction, stroke, cardiovascular mortality, inflammation, hypertriglyceridemia, low HDL cholesterol, hypertension, obesity
MeSH terms
Aged, C-Reactive Protein, Female, Follow-Up Studies, Heart Diseases, Humans, Middle Aged, Prognosis, Prospective Studies, Risk Factors, United States, Incidence, Prevalence, Disease-Free Survival, Metabolic Syndrome

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review