Increasing number of components of the metabolic syndrome and cardiac structural and functional abnormalities – cross-sectional study of the general population

Ana Azevedo¹^,2 , Paulo Bettencourt² , Pedro B Almeida³ , Ana C Santos¹ , Cassiano Abreu-Lima³ , Hans-Werner Hense⁴ and Henrique Barros¹

¹Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal

²Department of Internal Medicine, Hospital de S. João and University of Porto Medical School, Porto, Portugal

³Department of Cardiology, University of Porto Medical School, Porto, Portugal

⁴Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany

author email corresponding author email

BMC Cardiovascular Disorders 2007, 7:17doi:10.1186/1471-2261-7-17


Published:	7 June 2007

Abstract

Background

We aimed to assess whether we could identify a graded association between increasing number of components of the metabolic syndrome and cardiac structural and functional abnormalities independently of predicted risk of coronary heart disease by the Framingham risk score.

Methods

We conducted a cross-sectional study on a random sample of the urban population of Porto aged 45 years or over. Six hundred and eighty-four participants were included. Data were collected by a structured clinical interview with a physician, ECG and a transthoracic M-mode and 2D echocardiogram. The metabolic syndrome was defined according to ATPIII-NCEP. The association between the number of features of the metabolic syndrome and the cardiac structural and functional abnormalities was assessed by 3 multivariate regression models: adjusting for age and gender, adjusting for the 10-year predicted risk of coronary heart disease by Framingham risk score and adjusting for age, gender and systolic blood pressure.

Results

There was a positive association between the number of features of metabolic syndrome and parameters of cardiac structure and function, with a consistent and statistically significant trend for all cardiac variables considered when adjusting for age and gender. Parameters of left ventricular geometry patterns, left atrial diameter and diastolic dysfunction maintained this trend when taking into account the 10-year predicted risk of coronary heart disease by the Framingham score as an independent variable, while left ventricular systolic dysfunction did not. The prevalence of left ventricular diastolic dysfunction, and the mean left ventricular mass, left ventricular diameter and left atrial diameter increased significantly with the number of features of the metabolic syndrome when additionally adjusting for systolic blood pressure as a continuous variable.

Conclusion

Increasing severity of metabolic syndrome was associated with increasingly compromised structure and function of the heart. This association was independent of Framingham risk score for indirect indices of diastolic dysfunction but not systolic dysfunction, and was not explained by blood pressure level.