Ana Azevedo and colleagues, from the University of Porto Medical School, Portugal, investigated the possibility of a graded association between the number of features of metabolic syndrome and cardiac structural and functional abnormalities. Their study also investigated whether the associations found were independent of coronary heart disease risk as predicted by the Framingham risk score, a standard tool to predict the probability of having heart disease in the future.
The authors investigated a sample of urban Portuguese adults who were invited to a full screening interview including questionnaires, blood tests for cholesterol and glucose levels, and an ECG measurement. This was followed up with a structured clinical interview including a cardiovascular physical examination, transthoracic echocardiogram and pulsed Doppler evaluation. The results indicated that symptomatic heart failure and severe cardiac structural and functional abnormalities rise progressively with increasing degree of metabolic syndrome, regardless of symptoms. This association was independent of the 10-year predicted risk of coronary heart disease by Framingham risk score for indirect indices of diastolic dysfunction, but not systolic dysfunction.
Unlike in previous studies, the association between metabolic syndrome and heart disease found in this research is not fully explained by blood pressure levels, the authors suggest. “Metabolic syndrome may help predict an increased cardiovascular risk beyond that predicted by the more frequently used Framingham risk score,” Azevedo says.
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