NCEP-Defined Metabolic Syndrome, Diabetes, and Prevalence of Coronary Heart Disease Among NHANES III Participants Age 50 Years and Older
Abstract
Although the individual components of the metabolic syndrome are clearly associated with increased risk for coronary heart disease (CHD), we wanted to quantify the increased prevalence of CHD among people with metabolic syndrome. The Third National Health and Nutrition Examination Survey (NHANES III) was used to categorize adults over 50 years of age by presence of metabolic syndrome (National Cholesterol Education Program [NCEP] definition) with or without diabetes. Demographic and risk factor information was determined for each group, as well as the proportion of each group meeting specific criteria for metabolic syndrome. The prevalence of CHD for each group was then determined. Metabolic syndrome is very common, with ∼44% of the U.S. population over 50 years of age meeting the NCEP criteria. In contrast, diabetes without metabolic syndrome is uncommon (13% of those with diabetes). Older Americans over 50 years of age without metabolic syndrome regardless of diabetes status had the lowest CHD prevalence (8.7% without diabetes, 7.5% with diabetes). Compared with those with metabolic syndrome, people with diabetes without metabolic syndrome did not have an increase in CHD prevalence. Those with metabolic syndrome without diabetes had higher CHD prevalence (13.9%), and those with both metabolic syndrome and diabetes had the highest prevalence of CHD (19.2%) compared with those with neither. Metabolic syndrome was a significant univariate predictor of prevalent CHD (OR 2.07, 95% CI 1.66–2.59). However, blood pressure, HDL cholesterol, and diabetes, but not presence of metabolic syndrome, were significant multivariate predictors of prevalent CHD. The prevalence of CHD markedly increased with the presence of metabolic syndrome. Among people with diabetes, the prevalence of metabolic syndrome was very high, and those with diabetes and metabolic syndrome had the highest prevalence of CHD. Among all individuals with diabetes, prevalence of CHD was increased compared with those with metabolic syndrome without diabetes. However, individuals with diabetes without metabolic syndrome had no greater prevalence of CHD compared with those with neither.
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Among people with diabetes, having other metabolic syndrome factors indicates a higher risk of developing ASCVD in the future.
“In individuals with diabetes, the coexistence of other metabolic syndrome factors denotes a higher risk for future development of ASCVD.69”
From Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement (2005) · cites this paper as [69]
The combination of metabolic syndrome and hypertension has been reported to result in even higher morbidity and mortality.
“the combination of MS and hypertension has been reported to result in an even higher morbidity and mortality.11”
From Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension (2004) · cites this paper as [11]
Patients with metabolic syndrome or essential hypertension have a high cardiovascular risk.
“It is already known that MS or EHT patients have a high cardiovascular risk”
From Sympathetic Neural Activation in Nondiabetic Metabolic Syndrome and Its Further Augmentation by Hypertension (2004) · cites this paper as [11]
ASCVD risk is higher with MetS in the absence of T2D compared with T2D without MetS (13.9% vs. 7.5%).
“ASCVD risk is higher with MetS in the absence of T2D compared with T2D without MetS (13.9% vs. 7.5%, respectively) (13).”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [13]
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BackgroundDietary patterns, inflammation and the metabolic syndrome
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BackgroundThe Metabolic Syndrome and Alzheimer Disease
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BackgroundMethodAsian Americans have greater prevalence of metabolic syndrome despite lower body mass index
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- Authors
- Alexander, C. M., Landsman, P. B., Teutsch, S. M., & Haffner, S. M.
- Affiliations
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- The University of Texas at San Antonio Health Science Center (US)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2003-05-01
- Volume
- 52
- Issue
- 5
- Pages
- 1210-1214
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2151152924
- Cited by
- 1,475
- References
- 30
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 18 · 2023: 20 · 2022: 30 · 2021: 37 · 2020: 32 · 2019: 30 · 2018: 42 · 2017: 39 · 2016: 51 · 2015: 43 · 2014: 61 · 2013: 65 · 2012: 73
- FWCI
- 77.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- 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, coronary artery disease, prevalence, older adults, NCEP criteria, NHANES III, cardiovascular risk factors, blood pressure, HDL cholesterol
- MeSH terms
- Age Factors, Blood Pressure, Body Constitution, Coronary Disease, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Humans, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Patient Education as Topic, Physical Examination, Surveys and Questionnaires, Risk Factors, Smoking, United States, Prevalence, Metabolic Syndrome
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