Although the metabolic syndrome is increasingly recognized as an important cardiovascular disease (CVD) risk factor, the association between it and mortality is not completely established in the elderly. In this study, Mozaffarian and co-investigators of the Cardiovascular Health Study sought to examine the relationship between the metabolic syndrome (defined by the National Cholesterol Education Program clinical criteria) and risk of mortality in 4,258 US elderly subjects (mean age=73 years) followed for 15 years. Compared to participants without the metabolic syndrome, the hazard ratio for future mortality for individuals with the metabolic syndrome was 1.22 (95% CI, 1.11-1.34) after adjusting for potential confounders. They also investigated the risk associated with each metabolic syndrome criteria. After adjusting for potential confounders, the association between waist circumference, triglyceride, and HDL cholesterol levels with mortality risk was not significant. However, participants with an elevated blood pressure at baseline had an increased mortality risk [HR=1.32 (95% CI, 1.18-1.47)]. Participants with elevated blood glucose levels at baseline were also at increased mortality risk [HR=1.39 (95% CI, 1.26-1.53)]. Based on these results, the authors concluded that the metabolic syndrome had no predictive value beyond its individual risk factors in older adults.
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