A team of scientists has found that people carrying extra weight in their 40s and 50s, and who also had slightly raised blood pressure, cholesterol or blood sugar levels, were 35% more likely to have a stroke or heart attack over the next 30 years.
The researchers warned that people with this “cluster of slightly unhealthy traits” – known as metabolic syndrome – typically had a heart attack or stroke two years earlier, on average, than healthier people the same age, reports The Telegraph.
Dr Lena Lönnberg of Västmanland County Hospital, Sweden, who was lead researcher for the study, said: “Many people in their 40s and 50s have a bit of fat around the middle and marginally elevated blood pressure, cholesterol or glucose, but feel generally well, are unaware of the risks and do not seek medical advice.
“In fact, most people live with slightly raised levels for many years before having symptoms that lead them to seek healthcare.”
Unaware of the risks
She warned that because the individual “unhealthy traits” did not usually make people feel unwell, most people were unaware of the risks combined with excess weight.
On their own, diabetes, high blood pressure and obesity can damage the blood vessels.
But even if patients only have mild versions of each condition, having the three together can be particularly dangerous.
For the latest research, presented at the European Society of Cardiology Congress in Amsterdam, Swedish experts studied about 34 000 people in their 40s and 50s who attended a cardiovascular screening programme in Sweden between 1990 and 1999.
They were measured to see if they had a waist circumference above 102cm for men or 88cm for women, with other checks such as blood pressure and cholesterol.
Study participants were judged to have metabolic syndrome if they had three or more of: a high waist circumference; slightly raised cholesterol; slightly high blood pressure; and/or slightly high blood sugar levels.
Adjusted figures found those with metabolic syndrome were 35% more likely to suffer a non-fatal heart attack or stroke within three decades, with 32% of people with metabolic syndrome experiencing these compared with 22% of the control group.
Problems at a younger age
More than a quarter of those with metabolic syndrome died, compared with a fifth of their healthier peers – a 30% increase.
They were also more likely to experience serious health problems at a younger age. The average time to the first non-fatal heart attack or stroke was 16.8 years in the metabolic syndrome group and 19.1 years in the control group, a 2.3-year difference.
Study details
Early screening for metabolic syndrome opens a window of opportunity – learnings from a long-term, population-based study.
L Loennberg, M Rehn, J Leppert, J Ohrvik, A Chabok, M Damberg.
Presented at ESC 365 on 25 August 2023
Abstract
Introduction
The metabolic syndrome (MetS) represents a cluster of risk factors that predict cardiovascular disease (CVD) and type 2 diabetes. Early detection of MetS opens up for a successful treatment of the cardiovascular (CV) risk factors involved, hopefully leading to later advent of CVD in the general population.
Purpose
In this long-term, population-based study we aimed to investigate how presence of MetS, in middle-aged men and women, was associated with all-cause mortality and non-fatal CVD later in life.
Methods
Between 1990 -1999 a screening program was conducted among 40- and 50-year-old inhabitants in the County of Västmanland, Sweden. Data on lifestyle habits and socio-economic status were collected. Total cholesterol, fasting blood glucose, blood pressure, weight, height, waist and hip circumference were measured. Individuals that met three or more of the following risk factors were classified with MetS: waist circumference: ≥102 cm (men) and ≥88 cm (women), total cholesterol: ≥6.1 mmol/ l, blood pressure: ≥130 and/ or ≥85 mm Hg (or previous diagnosis of hypertension) or fasting plasma glucose: ≥5.6 mmol/ l (or previous diagnosis of type 2 diabetes). A control group was identified with individuals from the same population, without MetS diagnosis. Each participant with MetS was matched to two controls regarding sex, age and date for the health examination. The association between midlife MetS and all-cause mortality and non-fatal CV events (stroke and myocardial infarction) was adjusted for age, sex, smoking, physical inactivity, educational level, BMI, hip circumference and living alone or with family members. Multivariable cox regression and Kaplan-Meier analyses were used.
Results
A total number of 5084 individuals met the criteria for MetS and a control group of 10 168 individuals was identified. The median (Q1, Q3) follow-up time was 27 years (24.6, 30.1), corresponding to 130 820 and 269 696 person-years at risk in the MetS and the control group respectively. During follow up, 1317 MetS and 1904 control subjects died, implying 10 deaths in the MetS group and 7 deaths in the controls per 1000 person-years at risk (fig. 1). Cox analysis showed increased mortality in the MetS group compared to the controls, hazard ratio (HR) 1.30 (95% CI: 1.20-1.40); p<0.001. Non-fatal CV events in the MetS group and in the controls were 32.4% vs 22.8%, respectively (p<0.001); HR 1.35 (CI;1.25–1.46) (fig 2). Median time (Q1, Q3) for first non-fatal CV event was 16.8 years (9.9,22.3) in the MetS group and 19.1 (12.2, 23.6) for the controls.
Conclusions
Results from this long-term, population-based study underline that the risk of non-fatal CVD and all-cause mortality was significantly higher in individuals with asymptomatic MetS. Present results support previous studies that early identification of MetS with screening programs might open a window of opportunity for prevention of CVD and premature death in the general population.
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