Metabolic syndrome with mortality and major adverse cardiovascular events in an elderly population
Shailendra Kumar Karn1, Fang Zhao2, Yawei Xu1
1Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Insights
Metabolic syndrome (MS) independently predicts major adverse cardiovascular events (MACE) in older adults. Central obesity, hypertension, and hyperglycemia are key risk factors, highlighting the need for early MS management in the elderly.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) is a leading global health concern.
- Metabolic syndrome (MS) significantly contributes to major adverse cardiovascular events (MACE).
- Limited research exists on MS and long-term cardiovascular outcomes in elderly populations.
Purpose of the Study:
- To investigate the impact of MS on MACE in an elderly cohort.
- To identify specific MS components that predict MACE in older individuals.
Main Methods:
- Prospective cohort study of 3,352 elderly residents (Northern Shanghai Study).
- Average follow-up of 5.6 years.
- MS defined by modified NCEP ATP III criteria; MACE included non-fatal MI, stroke, cardiovascular death, and all-cause mortality. Kaplan-Meier and logistic regression analyses were employed.
Main Results:
- MS prevalence was 44.2% in the cohort.
- Higher MACE incidence in participants with MS (12.69%) versus without (9.30%), p=0.02.
- MS is an independent risk factor for MACE (HR 1.471, p=0.001); central obesity, hypertension, and hyperglycemia combination showed strongest prediction (HR 3.001, p<0.001).
Conclusions:
- Metabolic syndrome is an independent predictor of MACE in the elderly.
- Central obesity, hypertension, and hyperglycemia are critical risk factors within MS for MACE.
- Early identification and management of MS are crucial for reducing cardiovascular risk and improving outcomes in older adults.
Background:
Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality globally, with metabolic syndrome (MS) being a significant contributor to major adverse cardiovascular events (MACE). While the relationship between MS and CVD is well established, limited studies have focused on elderly populations, particularly in the context of long-term cardiovascular outcomes. This study aims to fill this gap by investigating the impact of MS and its components on MACE in an elderly population.
Methods:
We conducted a prospective cohort study involving 3,352 elderly residents from the Northern Shanghai Study (NSS), followed for an average of 5.6 years. MS was defined based on modified NCEP ATP III criteria. The primary outcome was MACE, including non-fatal myocardial infarction (MI), non-fatal stroke, cardiovascular death, and all-cause mortality. Kaplan-Meier survival analysis and multivariate logistic regression were used to examine the association between MS and MACE.
Results:
MS was present in 44.2% of the cohort. Participants with MS had a significantly higher incidence of MACE compared to those without MS (12.69% vs. 9.30%, p=0.02). MS was confirmed as an independent risk factor for MACE (HR 1.471, 95% CI 1.195-1.181, p=0.001). Among the individual components of MS, the combination of central obesity, hypertension, and hyperglycemia (ABD+BP+GLU) showed the strongest predictive value for MACE (HR 3.001, 95% CI 1.640-5.492, p<0.001).
Conclusions:
MS is an independent predictor of MACE in elderly populations, with central obesity, hypertension, and hyperglycemia being the most critical risk factors. These findings underscore the importance of early identification and management of MS to reduce cardiovascular risk and improve long-term outcomes in elderly individuals.
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