The metabolic syndrome and nonfatal ischemic heart disease; a population-based study

Objectives: Metabolic syndrome comprises insulin resistance, abdominal fat distribution, dyslipidemia and hypertension. The metabolic syndrome is expected to be diagnosed in millions of subjects in the near future worldwide. There are very few data in literature clearly documenting that subjects with metabolic syndrome have an increased cardiovascular risk. Design: Cross-sectional, population-based study. Materials and methods: We used National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATP)-III criteria and Minnesota Code of a 12-lead resting electrocardiogram (EKG) to assess the association of metabolic syndrome and nonfatal ischemic heart disease in 3723 subjects, aged 25 years and over, selected by cluster random sampling in three Iranian ports in the northern Persian Gulf. Electrocardiogram with evidence of IHD (IHD EKG) was defined as myocardial infarction (codes 1.1 and 1.2) and ischemia (codes 1.3, 4.1– 4.4, 5.1–5.3 and 7.1) together. Results: An estimated 49.08% (52.04% of males and 46.34% of females) were identified as fulfilling NCEP-ATP III criteria for diagnosing the metabolic syndrome. Prevalence of EKG with evidence of ischemic heart disease (IHD EKG) was 12.7% (10.4% for men and 14.7% for women, pb0.0001). In multiple logistic regression analysis, metabolic syndrome was found to have a significant association with IHD EKG [OR=1.35, CI (1.09–1.66), p=0.005] after adjusting for sex and age. Of the metabolic syndrome components, elevated blood sugar (OR=2.69, pb0.001), high blood pressure (OR=1.79, p=0.001) and low HDL-C (OR=1.27, p=0.02) had significant independent association with IHD EKG. Conclusion: The metabolic syndrome, which occurs very frequently in the general population, has a significant association with nonfatal ischemic heart disease by electrocardiogram criteria. © 2006 Elsevier Ireland Ltd. All rights reserved