Journal Article

Age- and sex- specific all-cause mortality risk greatest in metabolic syndrome combinations with elevated blood pressure from 7 U.S. cohorts

Randhawa, Arshdeep K., Yu, Winnie W., Sui, Xuemei, Blair, Steven N., Kuk, Jennifer L.

2019

Overview

The association between metabolic syndrome (MetS) and all-cause mortality is well established but it is unclear if there are differences in mortality risk among the 32 possible MetS combinations. Hence, the purpose of this study is to evaluate the associations between different MetS combinations and its individual components with all-cause mortality, and to examine differences in the association by age and sex. A merged sample of 82,717 adults from 7 U.S. cohorts was used. In our sample, MetS was present in 32% of men, 34% of women, 28% of younger adults (18-65 years) and 62% of older adults (>65 years) with 14,989 deaths over 14.6 ± 7.4 years of follow-up. Risk of all-cause mortality was higher in younger individuals with a greater number of MetS factors present, but in older adults having all 5 MetS factors was the only combination significantly associated with mortality. Regardless of age or sex, elevated blood pressure was the MetS factor most consistently present in MetS combinations that were significantly and most strongly associated with mortality. In fact, elevated blood pressure in the absence of other risk factors was significantly associated with mortality in men (HR, 95% CI = 1.56, 1.33-1.84), women (HR = 1.62, 1.44-1.81) and younger adults (HR = 1.61, 1.45-1.79). Conversely, waist circumference, glucose and triglycerides in isolation were not associated with mortality (p>0.05). In a large U.S. population, different combinations of MetS components vary substantially in their associations with all-cause mortality. Men, women and younger individuals with MetS combinations including elevated blood pressure had stronger associations with greater mortality risk, with minimal associations between MetS and mortality risk in older adults. Thus, we suggest that future algorithms may wish to consider differential weighting of these common metabolic risk factors, particularly in younger populations.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Adults / Age / Age Factors / Aged / Aged, 80 and over / Algorithms / Blood pressure / Blood Pressure - physiology / Blood Pressure Determination / Cardiovascular disease / Female / Glucose / Health aspects / Health risk assessment / Health risks / Humans / Hypertension / Hypertension - epidemiology / Longitudinal studies / Male / Measurement / Medicine and Health Sciences / Men / Metabolic diseases / Metabolic disorders / Metabolic syndrome / Metabolic Syndrome - epidemiology / Metabolic Syndrome - mortality / Middle Aged / Mortality / Mortality risk / Nutrition / Older people / Patient outcomes / People and Places / Physical Sciences / Proportional Hazards Models / Research and Analysis Methods / Risk analysis / Risk Factors / Sex / Sex Factors / Triglycerides / Triglycerides - blood / United States / Waist Circumference / Women / Young Adult