Metabolic syndrome raises risk of heart failure
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The findings of a new study suggest that the metabolic syndrome is a risk factor for heart failure, and this relationship is seen with or without the presence of other known heart failure risk factors, such as previous heart attack.
Individuals with the metabolic syndrome have a cluster of heart disease and diabetes risk factors, such as excess body weight, high blood pressure, high blood sugar and high cholesterol levels.
The results imply that the “metabolic syndrome provides important risk information beyond that of established risk factors for heart failure,” lead author Dr. Erik Ingelsson, from Uppsala University in Sweden, and colleagues note. They suggest that insulin resistance and higher than normal levels of insulin in the blood may underlie this increased heart failure risk in these patients.
The findings, which appear in the medical journal Heart, are based on a study of 2,314 men who were 50 years of age and free of heart failure, heart attack, and heart valve disease at study enrollment in the early 1970s. The men were then followed through age 70.
Ingelsson’s team used a modified version of the National Cholesterol Education Program’s definition of metabolic syndrome, which substituted measurement of waist circumference with body mass index (BMI), the ratio of height to weight often used to determine obesity. (A normal BMI is between 18.5 and 24.9 - obesity is defined as a BMI of 30 or greater.) The primary study outcome measure was having a first hospitalization for heart failure.
After analysis of the data, factoring in the effects of established heart failure risk factors, the investigators found that men with the metabolic syndrome at study entry had a 66 percent increased risk of developing heart failure during follow-up, compared with those without the metabolic syndrome. After accounting for heart attack during follow-up, the increased risk rose even further to 80 percent.
If these findings are confirmed, the researchers conclude, the metabolic syndrome may have direct effects on the heart, in addition to an increased risk of atherosclerosis.
SOURCE: Heart, June 2006.
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