The 10-year risk of CVD in subjects with the metabolic syndrome with/without abdominal obesity was examined in a sample of 30,378 Chinese subjects 35 to 64 years old. The prevalence of the metabolic syndrome in this cohort was 18%. Among subjects with the metabolic syndrome at baseline, 78% had abdominal obesity according to updated NCEP-ATP III clinical criteria for the Asian population. The subgroup of subjects with the metabolic syndrome without abdominal obesity had higher glucose and triglyceride concentrations and lower HDL cholesterol levels than those with the metabolic syndrome and abdominal obesity. There were also no significant differences in 10-year relative and absolute CVD risks between the two metabolic syndrome groups.