Background: The metabolic syndrome is a global health problem and is associated with subsequent development of cardiovascular disease (CVD). However, data are scarce concerning prospective association of the syndrome and CVD in populations free of diabetes and previous CVD that also is free of all cardiovascular drugs. The aim of this study was to assess the risk of cardiovascular events due to the metabolic syndrome in a population-based cohort of initially healthy, low-risk, and medication-free 58-year-old Swedish men during 13-years of follow-up.
Methods: From a total population sample of 1728 subjects, a stratified and randomly selected group of 391 subjects was included. The metabolic syndrome was defined according to the National Cholesterol Education Program. Cardiovascular events and cause of death were investigated by contact with the Centre of Epidemiology at the National Board of Health and Welfare.
Results: The metabolic syndrome increased the risk of cardiovascular events with a hazard ratio of 2.1 [95% confidence interval (CI) 1.3-3.4], P=0.003. When adjusted for the factors of leisure-time physical activity, smoking habits, alcohol intake, and low-density lipoprotein cholesterol (LDL-C), the hazard ratio was 2.0 (95% CI 1.1-3.4), P=0.016.
Conclusion: In a 13-year follow-up in initially healthy men, the metabolic syndrome increases the risk of cardiovascular events by two-fold. This risk was maintained also after adjustment for lifestyle factors.