NEW YORK (Reuters Health) Jan 22 - The metabolic syndrome (MetS) is associated with a significantly higher risk of incident ischemic stroke, and there is a clear dose-response relationship between the number of MetS components and stroke risk, researchers report.
They found the highest risk of ischemic stroke associated with MetS in subjects with either elevated blood pressure or elevated fasting glucose in the risk-factor cluster.
"Little is known about the particular MetS clusters and the risk differences in the development of ischemic stroke," Dr. Duanping Liao, of Pennsylvania State University College of Medicine, Hershey, and colleagues write in the January issue of Stroke.
To investigate, they analyzed data from the Atherosclerosis Risk in Communities Study involving 14,993 stroke-free subjects followed over 9 years for incident stroke. The participants had a mean age of 54 years, 26% were black, and 55% were females. The baseline prevalence of MetS was 39%.
A total of 210 cases of incident stroke were identified during follow-up. Of these, 188 were classified as ischemic stroke.
A significantly increased risk of stroke was observed among individuals with MetS compared to those without (RR, 2.24). The multivariable-adjusted RR for incident stroke associated with MetS was 2.41 among women and 2.11 among men.
A dose-response relationship was observed between the number of MetS components and the risk of incident stroke. Compared to subjects without any component of MetS, those with 1, 2, 3, 4, or 5 components had multivariable-adjusted hazard ratios for incident stroke of 1.36, 1.72, 2.48, 3.59, and 4.82, respectively.
The greatest risk of developing stroke was found in individuals with metabolic syndrome that had either hypertension or elevated fasting glucose.
"These findings provide a better understanding of the relationship between metabolic syndrome and stroke in the U.S. population," study authors Dr. Liao and Sol Rodriguez-Colon said in an email communication with Reuters Health.
"Considering that the developed countries are experiencing an obesity epidemic, and that stroke is the leading course of disability and the third leading course of death in the U.S. and other developed countries, our findings suggest the need to target metabolic syndrome, especially metabolic syndrome with these two highest risk components -- elevated blood pressure or elevated fasting glucose in the clusters -- in order to reduce the public health, individual, and family burden of stroke," they pointed out.
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