Abstract
We estimated the coronary heart disease (CHD) events that are preventable by treatment
of lipids and blood pressure in patients with metabolic syndrome (MetS), a contributor
to coronary heart disease (CHD). Among patients aged 30 to 74 years (without diabetes
or CHD) in the United States, MetS was defined by National Cholesterol Education Program
criteria. CHD events over a period of 10 years were estimated by Framingham algorithms.
Events that could be prevented by statistically “controlling” blood pressure, low-density
lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol to either
normal or optimal levels according to national guidelines were calculated. Of 7.5
million men and 9.0 million women aged 30 to 74 years with MetS, approximately 1.5
million men and 0.45 million women, if untreated, developed CHD events in 10 years.
In men and women, blood pressure control to normal levels “prevented” 28.1% and 12.5%
of CHD events, respectively (p <0.01); control to optimal levels resulted in preventing
28.2% and 45.2% of events, respectively (p <0.01). Control of HDL cholesterol to normal
levels resulted in preventing 25.3% of events in men and 27.3% in women; optimal control
prevented 51.2% and 50.6% of events, respectively. Control of LDL cholesterol to normal
levels prevented 9.3% of events in men and 9.8% of events in women; control to optimal
levels prevented 46.2% and 38.1% of events (p <0.05), respectively. Control of all
3 risk factors to normal levels resulted in preventing 51.3% of events for men and
42.6% for women; control to optimal levels resulted in preventing 80.5% and 82.1%
of events, respectively. Thus, many CHD events in patients with MetS may be preventable
by nominal or optimal control of lipids and/or blood pressure.
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Article info
Publication history
Accepted:
March 3,
2003
Received in revised form:
March 3,
2003
Received:
January 7,
2003
Footnotes
☆This study was supported by a grant from the Bristol-Myers Squibb, Pharmaceutical Research Institute, Princeton, New Jersey.
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.