"In women suspected of having an insufficient supply of blood to the heart, called myocardial ischemia, the presence of the metabolic syndrome is highly prognostic of future cardiovascular risk, whereas measurement of BMI alone appears to confer little independent value in determining cardiovascular risk," said Steven Reis, M.D., associate professor of medicine at the University of Pittsburgh School of Medicine and senior author of the study. "Abnormal metabolism was independently associated with a significantly increased risk of death or a major adverse cardiovascular event."
People with three or more of the following criteria are classified as having metabolic syndrome: waist circumference greater than 35 inches, fasting triglycerides greater than 150mg/dl, HDL cholesterol less than 50mg/dl, hypertension or the use of anti-hypertensive drug therapy, and fasting glucose greater than 110mg/dl.
The study included 780 women enrolled in the WISE study, ages 21 to 86 years, in whom the presence or absence of metabolic syndrome could be determined. All women were clinically referred for coronary angiography to evaluate suspected myocardial ischemia at one of four study sites. Each woman had a baseline evaluation that included collection of demographic information, risk factors for coronary artery disease, medication use, medical and reproductive history, symptom and psychosocial evaluation, a physical examination with blood pressure and physical measurements, and sampling of blood in the fasting state for lipid, glucose, insulin, reproductive hormone, and inflammatory marker core lab evaluations.