Metabolic syndrome, abdominal obesity, and cardiovascular risk in elderly women

Background: Metabolic syndrome and abdominal obesity are risk factors for cardiovascular diseases in middle age women but, not completely understood in older people. In this study we analyzed the association between metabolic syndrome and abdominal obesity and the occurrence of cardiovascular events in these elderly women. Methods: A prospective follow-up study included 516 consecutive women aged 60-84 years who sought medical care at a geriatric outpatient facility. The presence of metabolic syndrome and higher quartiles of waist circumference and waist-to-hip ratio were analyzed as predictive variables, and were adjusted for age, smoking, and previous cardiovascular diseases. The outcomes were the occurrence of stroke, myocardial infarction, evidence of coronary artery disease, or cardiovascular death. Results: During a mean follow-up of 6.6 years, 94 (18.2%) cardiovascular events were observed (48 fatal and 46 non-fatal). Metabolic syndrome was diagnosed in 206 women (39.9%). After adjustments for confounding variables, metabolic syndrome and waist-to-hip ratio above the 75th percentile (> 0.98) were predictors of the outcomes, but greater waist circumference (> 96 cm) was not. Adjusted hazard ratios for these variables were: metabolic syndrome, 1.66, 95% CI - 1.11 to 2.47, p = 0.01; waist-to-hip ratio, 1.72, 95% CI - 1.05 to 2.82; p = 0.03 and waist circumference, 1.37, 95% CI - 0.91 to 2.07, p = 0.12. Conclusion: Metabolic syndrome and high waist-to-hip ratio were associated with increased risk of cardiovascular events in the studied sample.