Investigators of the Rancho Bernardo Study examined the prevalence of the metabolic syndrome determined using either the World Health Organization (WHO) or the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) clinical criteria in older community-dwelling ambulatory adults (n=338) without known coronary heart disease and the independent association of baseline metabolic syndrome or components with coronary artery calcium (CAC) progression. Metabolic syndrome prevalence was 15.1% and 11.8% according to WHO and NCEP-ATP III clinical criteria, respectively. Change in total CAC volume score was greater in subjects meeting the WHO criteria of the metabolic syndrome compared to those without the metabolic syndrome. An increase in CAC was observed in 46.4% of the cohort. Although the metabolic syndrome did not predict CAC progression, hypertension was independently associated with CAC progression (odds ratio=2.11, 95% CI: 1.33-3.3, p=0.002), while fasting glucose >5.6 mmol/l was an independent predictor only in subjects younger than 65 years (odds ratio=2.3, 95% CI: 1.01-5.5, p=0.04).
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