Metabolic syndrome and the risk of incident heart failure: a prospective cohort study

Previous studies have reported the link between metabolic syndrome (MetS) and multiple cardiovascular diseases. This study aimed to comprehensively investigate the role of MetS in the risk of developing HF.

This is a prospective cohort study based on UK Biobank. The components of MetS included increased blood pressure (P), central obesity (W), elevated blood glucose (G), reduced HDL cholesterol (H) and increased triglycerides (T); the cumulative burden of MetS components was defined as the sum of the presence of altered MetS components; and specific clusters of MetS components was defined as different combinations of the altered components. The outcome was incident heart failure. Cox proportional-hazards models were used to generate the estimates.

Over a median follow-up for 13.2 years, 11,875 cases of incident HF occurred. As compared to individuals without altered component of MetS, the adjusted HRs gradually increased from 1.54, 1.64, 1.86, 2.18 to 2.62 across groups with 1-5 altered components, respectively. Increased blood pressure conferred a greater risk of HF than other components after adjustment, while increased triglycerides showed a protective effect, resulting in the highest risk observed in the clusters of PGHW (adjusted HR = 3.17, 95 % CI = 2.70-3.72), followed by PGHTW, PGW, PGH, and PGTW. These observed associations were almost stronger in younger adults than older participants, or in females than males.

Cumulative burden of MetS was associated with higher incidence of HF, while which varied by different clusters.