Presence of diabetes mellitis increased with increasing BMI for both men and women. Although the proportion of patients with hypertension was high for all weight categories, blood pressure also increased with increased BMI, although more modestly. The proportion with dyslipidemia increased with increasing BMI for men, but not for women. In this study, the authors defined metabolic syndrome as the presence of obesity, hypertension, diabetes and dyslipidemia, and found that the three risk factors (hypertension, dyslipidemia and diabetes) were present in 26.1 percent of men and 34.7 percent of women with class one obesity, in 29.4 percent of men and 31.3 percent of women with class two obesity and in 43.3 percent of men and 29.1 percent of women with class three obesity. Metabolic syndrome increases cardiovascular risk more than any of the individual factors which comprise it.

"A metabolic syndrome was seen in 21 percent of men and 29 percent of women in the AAASPS," the authors write. 'Although BMI was not an independent predictor of stroke occurrence, obesity nearly doubled the odds of having a metabolic syndrome compared with the odds of those with a normal BMI having DM, HTN and DL. Furthermore, increasing BMI had a negative association with blood pressure and glycemic [blood sugar] control."

"Our data support the association of increasing risk factor profiles and decreasing risk factor control with increasing weight," the authors conclude. "This is particularly important in African American stroke survivors, as this group has been shown to have a worse risk factor profile than their non-African-American counterparts, putting them at high risk for recurrent stroke. Furthermore, the high morbidity [illness] and mortality [death] due to stroke in African-Americans should make this an increasing area of public health concern."

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Contact: Sharon Butler
312-355-2522
JAMA and Archives Journals
14-Mar-2005