Prevalence of coronary heart disease and carotid arterial thickening in patients with the metabolic syndrome (The ARIC Study)

• Published in: The American journal of cardiology Vol. 94; no. 10; pp. 1249 - 1254
• Main Authors: McNeill, Ann Marie, Rosamond, Wayne D., Girman, Cynthia J., Heiss, Gerardo, Golden, Sherita Hill, Duncan, Bruce B., East, Honey E., Ballantyne, Christie
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.11.2004; Elsevier; Elsevier Limited
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Carotid Artery Diseases - complications; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Coronary Disease - complications; Coronary Disease - diagnosis; Coronary Disease - epidemiology; Coronary heart disease; Coronary vessels; Cross-Sectional Studies; Female; Heart; Humans; Male; Medical disorders; Medical sciences; Metabolic diseases; Metabolic Syndrome - complications; Middle Aged; Miscellaneous; Other metabolic disorders; Prevalence; Risk Factors; Tunica Intima - diagnostic imaging; Tunica Media - diagnostic imaging; Ultrasonography; Endocrinopathy; Human; Prevalence; X Syndrome; Carotid; Cardiovascular disease; Metabolic diseases; Epidemiology; Coronary heart disease; Thickening
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2004.07.107

We determined the prevalence of the metabolic syndrome (MS) with the criteria recommended by the National Cholesterol and Education Program, Adult Treatment Panel III report and estimated the magnitude of cross-sectional associations between the MS, coronary heart disease (CHD), and atherosclerosis in 14,502 black and white middle-age patients in the Atherosclerosis Risk in Communities Study. CHD was ascertained by standardized procedures and subclinical atherosclerosis was determined by measuring carotid intimal medial wall thickness using B-mode ultrasonography. The prevalence of MS was 30%, with substantial variation across race and gender subgroups. Among women but not among men, MS was significantly associated with increasing low-density lipoprotein cholesterol. CHD prevalence was 7.4% among those with the MS compared with 3.6% in comparison subjects (p <0.0001). After adjustment for established risk factors, subjects who had MS were 2 times more likely to have prevalent CHD than were those who did not have the syndrome. Among individuals free of CHD and stroke, after adjustment for age, gender, and race/center, the average intimal-medial wall thickness of carotid arteries was greater among those with versus those without MS (747 vs 704 μm, p <0.0001). Thus, MS was significantly associated with the presence of CHD and carotid intimal medial wall thickness. Identification of patients who have MS may provide opportunities to initiate CHD prevention strategies.