Cardiovascular disease risk factors and the perception of general health among male law enforcement officers: encouraging behavioral change.

The relationship among cardiovascular disease (CVD) morbidity, risk factors (including stress), and the perception of health among male law enforcement officers (LEOs) compared to men in the general population were examined in this study. Self reported prevalence of CVD and CVD risk factors among currently employed male LEOs from nine states (n = 2,818) were compared to those of other men in the same states (n = 9,650 for CVD risk factors, n = 3,147 for CVD prevalence). Perceived stress in LEOs was assessed to determine if it affected the relationship between CVD prevalence and CVD risk factors. Cross tabulated simple percentages showed CVD was less prevalent in the LEO group than among the general population. The best predictor variables for CVD were perceived stress, time in the profession, and hypertension. The LEO group had greater prevalence of hypercholesterolemia, overweight, and tobacco use than the general population. However, a greater percentage of LEOs perceived their health as "good to excellent" compared to men in the general population. Using multivariate analysis of variance (MANOVA) it was determined that perceived stress was associated with CVD in the LEO group and three CVD risk factors (i.e., cholesterol, hypertension, physical activity) were significantly affected by perceived stress. Among susceptible officers, stress may contribute to CVD development as well as potentiate several CVD risk factors. However, an apparent lack of association exists between perception of general health and CVD risk in LEOs.     

Health Risks among People with Severe Mental Illness in Psychiatric Outpatient Settings

Life expectancy is greatly reduced in patients with schizophrenia, and cardiovascular diseases are a leading cause of mortality. The aim of this cross-sectional study was to investigate the prevalence of overweight, obesity, and cardiovascular disease (CVD) risk and to investigate the relationships between self-rated health, sense of coherence, CVD risk, and body mass index (BMI) among people with severe mental illness (SMI) in psychiatric outpatient settings. Nearly 50% of the participants were exposed to moderate/high risk of CVD and over 50% were obese. The results showed no statistically relationships between the subjective and objective measures (Bayes factor <1) of health. The integration of physical health into clinical psychiatric nursing practice is vital.     

Trends in lifestyle cardiovascular risk factors in women: analysis from the Canadian National Population Health Survey.

Cardiovascular disease (CVD) is the leading cause of death and disability among women. The present investigation analyzed data from the National Population Health Survey to examine the prevalence trends of self-reported lifestyle CVD risk factors in adult women. Results indicated an upward prevalence trend in physical activity and high blood pressure, and significant increased prevalence rates in obesity in the lower middle and middle income groups. Logistic regression analysis showed that increased physical activity and advancing age were significant predictors of CVD; age confers more than a one-fold risk for developing heart disease and hypertension. Implications of the study results for nursing practice are discussed.     

Are nutrition-induced epigenetic changes the link between socioeconomic pathology and cardiovascular diseases?

The prevalence of cardiovascular diseases (CVD) and diabetes mellitus type 2 (DM 2) is decreasing in developed countries despite the increase in the percentage of subjects with obesity and other well-recognized cardiovascular risk factors. In contrast, the recent transition of the economic model experienced by developing countries, characterized by the adoption of a Western lifestyle, that we have named "socioeconomic pathology," has led to an increase in the burden of CVD. It has been demonstrated that conventional cardiovascular risk factors in developed and developing countries are the same. Why then does the population of developing countries currently have a higher incidence of CVD than that of developed countries if they share the same risk factors? We have proposed the existence of a higher susceptibility to the development of systemic inflammation at low levels of abdominal obesity in the population of developing countries and the consequent endothelial dysfunction, insulin resistance, DM 2, and CVD. In contrast, an important percentage of obese people living in developed countries have a healthy phenotype and low risk of developing CVD and DM 2. Human epidemiologic studies and experimental dietary interventions in animal models have provided considerable evidence to suggest that nutritional imbalance and metabolic disturbances early in life may later have a persistent effect on an adult's health that may even be transmitted to the next generations. Epigenetic changes dependent on nutrition could be key in this evolutionary health behavior, acting as a buffering system, permitting the adaptation to environmental conditions by silencing or increasing the expression of certain genes.     

Cardiovascular disease prevention and lifestyle interventions: effectiveness and efficacy

Over the past half century scientific data support the strong relationship between the way a person or population lives and their risk for developing or dying from cardiovascular disease (CVD). While heredity can be a major factor for some people, their personal health habits and environmental/cultural exposure are more important factors. CVD is a multifactor process that is contributed to by a variety of biological and behavioral characteristics of the person including a number of well-established and emerging risk factors. Not smoking, being physically active, eating a heart healthy diet, staying reasonably lean, and avoiding major stress and depression are the major components of an effective CVD prevention program. For people at high risk of CVD, medications frequently need to be added to a healthy lifestyle to minimize their risk of a heart attack or stroke, particularly in persons with conditions such as hypertension, hypercholesterolemia, or hyperglycemia. Maintaining an effective CVD prevention program in technologically advanced societies cannot be achieved by many high-risk persons without effective and sustained support from a well-organized health care system. Nurse-provided or nurse-coordinated care management programs using an integrated or multifactor approach have been highly effective in reducing CVD morbidity and mortality of high-risk persons.     

Chronic kidney disease (CKD) as an independent risk factor for cardiovascular disease (CVD)

Chronic kidney disease (CKD) has been shown to be an independent risk factor for cardiovascular disease (CVD) in a number of recent epidemiological studies. There are possible explanations for the independent association of CKD with CVD. Reduced renal function is associated with a high prevalence of traditional CVD risk factors, such as hypertension, diabetes, dyslipidemia, and left ventricular hypertrophy. In addition, reduced renal function may be associated with increased levels of nontraditional risk factors, such as inflammation and oxidative stress. Subjects with CKD should be considered a high-risk population for CVD and be recommended for more intensive preventive management of CVD, including active detection and strict treatment of CVD risk factors.     

Evaluation of therapeutic control in a Pakistani population with hypertension

Rationale, aims and objectives Cardiovascular diseases (CVD) are increasing at an alarming rate in South Asia. High blood pressure is a modifiable risk factor for CVD. In this study, we evaluated the control of blood pressure and the prevalence of cardiovascular risk factors in patients with hypertension. Method A cross‐sectional study was conducted in 50 primary health care centres throughout Pakistan. Individuals with a documented history of hypertension, receiving pharmacological therapy, were enrolled and evaluated for the control of their blood pressure. Results The recommended therapeutic control of hypertension (systolic blood pressure <140 mmHg, diastolic blood pressure <90 mmHg) was seen in only 6.4% of the study participants. Values of both the mean systolic and diastolic blood pressures in all subjects were higher than the desired therapeutic levels (P < 0.001). There was a high prevalence in the study population of established but modifiable risk factors of CVD, such as smoking (30.5%), hypercholesterolemia (59.5%) and sedentary lifestyle (43.5%). Lack of therapeutic control of systolic blood pressure was found significantly associated with age, hypercholesterolemia and sedentary lifestyle (P < 0.05). Conclusions Patients being treated at primary health care centres in Pakistan have inadequate control of high blood pressure. Evidence‐based continuous education of primary health care physicians is a necessary intervention for optimizing treatment strategies and achieving better therapeutic control of hypertension in our population.     

Inflammation in peritoneal dialysis: a Latin-American perspective.

Peritoneal dialysis (PD) patients present an extremely high mortality rate, but the mechanisms mediating the increased risk of mortality observed in this group of patients are still largely unknown, which limits the perspective of effective therapeutic strategies. The leading hypothesis that tries to explain this high mortality risk is that PD patients are exposed to a number of traditional risk factors for cardiovascular disease (CVD) already at the onset of their chronic kidney disease (CKD), since many of these risk factors are common to both CVD and CKD. Of particular importance, chronic inflammation recently emerged as an important novel risk factor related to multiple complications of CKD. There are many stimuli of the inflammatory response in CKD patients, such as fluid overload, decreased cytokine clearance, presence of uremia-modified proteins, presence of chronic infections, metabolic disturbances (including hyperglycemia), obesity. Many of these factors are related to PD. Latin America has made some progress in economic issues; however, a large portion of the population is still living in poverty, in poor sanitary conditions, and with many health-related issues, such as an increasing elderly population, low birth weights, and increasingly high energy intake in the adult population, which, in combination with changes in lifestyle, has provoked an increase in the prevalence of obesity, diabetes, and CVD. Therefore, in Latin America, there seems to be a peculiar situation combining high prevalence of low education level, poor sanitary conditions, and poverty with increases in obesity, diabetes, and sedentary lifestyle. Since inflammation and mortality risk are intimately related to both sides of those health issues, in this review we aim to analyze the peculiarities of inflammation and mortality risk in the Latin-American PD population.     

Cardiovascular disease: the effect of erectile dysfunction on adherence to cardiovascular disease medication

Due to their similar aetiologies, cardiovascular disease (CVD) and erectile dysfunction (ED) are closely linked, with the prevalence of ED being approximately 75% for individuals at high risk of CVD. ED can have a detrimental effect on quality of life not only for the individual but also his sexual partner which in turn impacts upon their intimate relationship. Some CVD medications have been found to have a negative effect on erectile function and therefore act as an influential factor for the cessation of important CVD medication. Low adherence to CVD medication has been linked to increased health costs, hospitalizations and importantly, a higher risk of mortality. Research has shown that men find it difficult to seek medical help in relation to ED which is also compounded by the notion that health care providers do not address sexual issues adequately. Patients' beliefs about CVD medication are modifiable and therefore an opportunity exists not only for health care providers to facilitate discussions in relation to ED and medication adherence but also encompass an opportunity to increase adherence to CVD medication through intervention.     

Association between knowledge and risk for cardiovascular disease among older adults: A cross-sectional study in China

ObjectivesThis study aimed to describe cardiovascular risk and cardiovascular disease (CVD) knowledge among older adults, and further explore the association between knowledge and risk.MethodsIn this cross-sectional study, we enrolled 1120 older adults who received physical examination in health centers. The participants were interviewed to obtain their behavioral risk factors related to CVD and clinical characteristics. A risk prediction chart was used to predict participants’ cardiovascular risk based on clinical characteristics and behavioral risk factors. Participants’ CVD knowledge was collected with a pretested knowledge questionnaire.ResultsAmong the 1120 participants, 240 (21.4%) had low cardiovascular risk, 353 (31.5%) had moderate cardiovascular risk, 527 (47%) had high and very high cardiovascular risk. The knowledge level about CVD among 0.8% of the 1120 participants was good while that of 56.9% was poor. Lower CVD knowledge level, older age, lower income, and lower educational level were the independent factors of higher cardiovascular risk level.ConclusionsThis study highlights the need to reduce the cardiovascular risk among older adults. CVD knowledge should be considered when developing health interventions.     

High prevalence of chronic venous disease in hospital employees

OBJECTIVES: Chronic venous disease (CVD), which comprises primary/idiopathic abnormalities of the venous system, and secondary sequels after deep venous thrombosis are major health issues in Western countries. The present study was conducted to prove the hypothesis that the development of CVD might be triggered by exogenous, occupational risk factors. METHODS: We determined the prevalence and social relationship of CVD in a wide cross-section of hospital employees (n = 209; medical doctors and nurses, medical technician assistants, secretaries, scientific staff, cleaners and utility workers) without predocumented CVD. Prevalence, known endogenous risk factors for CVD and occupational and environmental risk factors (family history of venous disease, history of deep venous thrombosis, current oral contraceptive therapy, obesity, regular participation in sports or frequent use of saunas or sun-baths, and long periods of standing during work) were investigated. The restriction in quality of life due to symptoms of CVD was also evaluated. CVD was classified according to the CEAP criteria. RESULTS: CVD was present in a total of 70 employees (34%), predominantly in women. Standing at work was a predisposing factor. We found the highest prevalence of CVD in utility workers and cleaners and the lowest prevalence in medical technician assistants, secretaries and scientific staff. CONCLUSION: The study demonstrated that within a representative cross-section of hospital employees in a University hospital the prevalence of CVD was highest in women, especially in those working in a standing position or under conditions of high temperature and humidity. The results warrant regular evaluation of risk factors with subsequent primary prophylaxis of CVD.     

Promoting Health and Wellness in the Workplace: A Unique Opportunity to Establish Primary and Extended Secondary Cardiovascular Risk Reduction Programs

Given the burden of cardiovascular disease (CVD), increasing the prevalence of healthy lifestyle choices is a global imperative. Currently, cardiac rehabilitation programs are a primary way that modifiable risk factors are addressed in the secondary prevention setting after a cardiovascular (CV) event/diagnosis. Even so, there is wide consensus that primary prevention of CVD is an effective and worthwhile pursuit. Moreover, continual engagement with individuals who have already been diagnosed as having CVD would be beneficial. Implementing health and wellness programs in the workplace allows for the opportunity to continually engage a group of individuals with the intent of effecting a positive and sustainable change in lifestyle choices. Current evidence indicates that health and wellness programs in the workplace provide numerous benefits with respect to altering CV risk factor profiles in apparently healthy individuals and in those at high risk for or already diagnosed as having CVD. This review presents the current body of evidence demonstrating the efficacy of worksite health and wellness programs and discusses key considerations for the development and implementation of such programs, whose primary intent is to reduce the incidence and prevalence of CVD and to prevent subsequent CV events. Supporting evidence for this review was obtained from PubMed, with no date limitations, using the following search terms: worksite health and wellness, employee health and wellness, employee health risk assessments, and return on investment. The choice of references to include in this review was based on study quality and relevance.     

Association of Cardiovascular Disease Risk Factors With Sociodemographic Characteristics and Health Beliefs Among a Community-Based Sample of African American Adults in Minnesota

ObjectiveTo assess cardiovascular disease (CVD) and CVD risk factors and their association with sociodemographic characteristics and health beliefs among African American (AA) adults in Minnesota.MethodsA cross-sectional analysis was conducted of a community-based sample of AA adults enrolled in the Minnesota Heart Health Program Ask About Aspirin study from May 2019 to September 2019. Sociodemographic characteristics, health beliefs, and self-reported CVD and CVD risk factors were collected. Prevalence ratio (PR) estimates were calculated using Poisson regression modeling to assess the association between participants’ characteristics and age- and sex-adjusted CVD risk factors.ResultsThe sample included 644 individuals (64% [412] women) with a mean age of 61 years. Risk factors for CVD were common: hypertension (67% [434]), hyperlipidemia (47% [301]), diabetes (34% [219]), and current cigarette smoking (25% [163]); 19% (119) had CVD. Those with greater perceived CVD risk had a higher likelihood of prevalent hyperlipidemia (PR, 1.34; 95% CI, 1.14 to 1.57), diabetes (PR, 1.61; 95% CI, 1.30 to 1.98), and CVD (PR 1.61; 95% CI, 1.16 to 2.23) compared with those with lower perceived risk. Trust in health care provider was high (83% [535]) but was not associated with CVD or CVD risk factors.ConclusionIn this community sample of AAs in Minnesota, CVD risk factors were high, as was trust in health care providers. Those with greater CVD risk perceptions had higher CVD prevalence. Consideration of sociodemographic and psychosocial influences on CVD and CVD risk factors could inform development of effective cardiovascular health promotion interventions in the AA Minnesota community.     

The feasibility and outcome of a community-based primary prevention program for cardiovascular disease in the 21st century

ObjectiveThere is no evidence that systematic screening and risk factor modification in an unselected, asymptomatic population will reduce cardiovascular disease (CVD) mortality. This study aimed to evaluate the effectiveness of a primary care CVD prevention program on mortality during a 13-year follow-up.DesignA risk factor survey was sent, followed by a nurse-led lifestyle counselling to respondents with at least one CVD risk factor, and a general practitioner’s (GP) appointment for high-risk persons. Screening and interventions were performed during 2005–2006.SettingA public health care centre in the town of Harjavalta, Finland.SubjectsAll home-dwelling 45–70-year old inhabitants without manifested CVD or diabetes.Main outcome measuresAll-cause and CVD mortality.ResultsAltogether 74% (2121/2856) inhabitants responded to the invitation. The intervention was received by 1465 individuals (52% of the invited population): 398 risk persons had an appointment with a nurse, followed by an appointment with a GP for 1067 high-risk persons. During the follow-up, 370 persons died. Mortality among the non-respondents was twofold compared to the participants’. In subjects who received the intervention, the age- and gender-adjusted hazard ratio for all-cause mortality was 0.44 (95% CI: 0.36 to 0.54) compared to the subjects who did not receive the intervention.ConclusionsReducing mortality is possible in a primary care setting by raising health awareness in the community with screening, by targeted lifestyle counselling and evidence-based preventive medication for persons at high risk for CVD. Subjects not willing to participate in health surveys have the worst prognosis.

Key Points

• Previously, there is no evidence that systematic screening and risk factor modification in an unselected, asymptomatic population will reduce cardiovascular disease (CVD) mortality.
• With a stepwise screening program it is possible to scale the magnitude of CVD prevention in the community.
• Reducing mortality in a community is possible by screening, targeted lifestyle counselling, and by evidence-based preventive medication for high-risk persons.
• Subjects not willing to participate in health surveys have the worst prognosis.

     

Philosophical and ethical perspectives on cardiovascular disease risk in low-wage workers

ABSTRACT One of the overriding goals of Healthy People 2010 is to reduce the health disparities observed among Americans. Because workers in small businesses tend to have little or no access to health screening or preventive health education programs, they may be unaware of their unique risk factors and are thus more at risk of cardiovascular disease (CVD). Furthermore, occupational health nurses are more likely to be available in health programs to employees in large rather than small businesses. The purpose of this paper is to illustrate how nursing values and philosophy might influence public health nurses' thinking about nursing science and ethical issues relating to the risk of CVD among low‐wage workers. The following questions will guide the exploration of health disparities among low‐wage workers: (a) What are the health disparities observed among low‐wage workers with CVD risk? (b) What are the philosophical and ethical perspectives on the issues presented? (c) Based on these findings, how should limited resources be allocated? and (d) How does this affect nursing? These approaches will provide the foundation for developing a culturally sensitive ethical and philosophical perspective to prevent CVD and promote cardiovascular health among low‐wage workers.     

Hyperhomocysteinemia in chronic renal failure patients: relation to nutritional status and cardiovascular disease.

A moderate increase in plasma total homocysteine (tHcy) is considered to be an independent risk factor for cardiovascular disease (CVD) in the general population. Almost all chronic renal failure (CRF) patients have plasma concentration of tHcy that is elevated 3 to 4 times above normal. The prevalence of CVD, diabetes mellitus, malnutrition and hypoalbuminemia is high in CRF patients. Previous investigations have focused on the role of vitamin status on plasma tHcy in CRF patients, but little information exists on the influence of nutritional status and hypoalbuminemia on plasma tHcy in CRF, although a substantial fraction of tHcy (>70%) is protein-bound, mainly to albumin. Our study in patients with end-stage renal disease showed that more than 90% of the patients had elevated plasma tHcy levels, which were higher in patients with normal nutritional status than in malnourished patients. Moreover, plasma tHcy was inversely correlated with subjective global nutritional assessment (high values denote malnutrition) and positively correlated with serum albumin and protein intake. Hence, it seems likely that serum-albumin is a strong determinant of plasma tHcy in CRF patients and this may contribute to the lower tHcy levels in malnourished patients. Patients with diabetes mellitus had lower serum-albumin and plasma tHcy than non-diabetic patients, irrespective whether they were malnourished or not. Patients with CVD had lower (although still elevated) plasma tHcy levels than those without CVD. An explanation may be that the prevalence of diabetes mellitus, malnutrition and hypoalbuminema, i.e. factors that decrease tHcy, was higher in patients with CVD, which may explain why they had less elevated values. Assuming that hyperhomocysteinemia carries an independent risk of CVD, this implies that almost all CRF patients are exposed to this risk. CRF patients with CVD had a higher prevalence of malnutrition, hypoalbuminemia and diabetes mellitus, which was associated with a lower plasma Hcy level. This may explain why plasma tHcy was lower (although still abnormally high) in patients with CVD than in patients without CVD. The lower tHcy levels in CVD patients do not contradict the assumption that hyperhomocysteinemia is a risk factor for CVD since almost all patients are exposed to this risk, and other factors might be present that confound the relationship between the absolute tHcy levels and CVD. Our findings imply that nutritional status and serum albumin, as well as the presence of diabetes mellitus, should be taken into consideration when evaluating tHcy as a risk factor for CVD in CRF patients.     

Cardiovascular risk factors among youth with and without type 2 diabetes: differences and possible mechanisms

OBJECTIVE—To compare cardiovascular disease (CVD) risk factors among recently diagnosed youth with type 2 diabetes and nondiabetic youth and investigate whether demographic, behavioral, or metabolic factors might account for observed differences.RESEARCH DESIGN AND METHODS—Data from 106 type 2 diabetic and 189 nondiabetic multiethnic youth, aged 10–22 years, were analyzed. Prevalence of CVD risk factors were age and race/ethnicity adjusted using direct standardization. Multiple linear regression models were sequentially adjusted for demographic, behavioral (dietary saturated fat intake and physical activity), and metabolic (body adiposity and glycemia) factors to explore possible mechanisms associated with differences in CVD risk factors between the case and control groups.RESULTS—Compared with control subjects, youth with type 2 diabetes had a higher prevalence of elevated blood pressure, obesity, large waist circumference, low HDL cholesterol, high triglycerides, and high albumin-to-creatinine ratio (P < 0.05 for each risk factor). Type 2 diabetic youth also had higher levels of apolipoprotein B, fibrinogen, interleukin (IL)-6, C-reactive protein, and leptin; lower adiponectin levels; and denser LDL particles (P < 0.05 for each risk factor). Adjustment for BMI, waist circumference, and A1C substantially attenuated differences in the CVD risk factors between the case/control groups, except for fibrinogen and IL-6, which remained significantly higher in type 2 diabetic youth.CONCLUSIONS—Compared with control youth, type 2 diabetic youth have a less favorable CVD risk factor profile. Adiposity and glycemia are important contributors to differences in CVD risk profiles among type 2 diabetic and control youth. Inflammatory and prothrombotic factors may also play an important role.There has been a dramatic increase in the prevalence of type 2 diabetes in children and adolescents during the past two decades (1). Much of the health burden of type 2 diabetes in youth will result from chronic complications, including cardiovascular disease (CVD) (2). In adults with type 2 diabetes, CVD occurs earlier and is associated with higher mortality compared with the general population (3). Early adult-onset type 2 diabetes (diagnosed age 18–44 years) has been associated with more aggressive CVD than later-onset type 2 diabetes (4), suggesting that CVD complications resulting from type 2 diabetes diagnosed in youth may be even more unfavorable.Obesity, dyslipidemia, hypertension, and smoking have long been recognized as major risk factors for cardiovascular morbidity and mortality in adults. The typical lipid abnormalities in type 2 diabetic adults are low levels of HDL cholesterol and high levels of triglycerides (5). Studies have recently identified novel lipid abnormalities, including a preponderance of small, dense LDL particles and high levels of apolipoprotein B (apoB) (6). Other novel CVD risk factors indicate systemic inflammation, a prothrombotic state, and endothelial dysfunction, marked by altered levels of interleukin (IL)-6, C-reactive protein (CRP), fibrinogen, adipocytokines, and microalbuminuria.Given the recent emergence of type 2 diabetes in adolescent populations, the relationship between type 2 diabetes and CVD risk factors among youth has not been well characterized. Although type 2 diabetes itself is considered a risk factor for CVD, we hypothesized that youth with recently diagnosed type 2 diabetes would have a less favorable CVD risk factor profile, excluding diabetes status, compared with nondiabetic youth. We also explored whether measures of adiposity (BMI and waist circumference), hyperglycemia, and behavioral factors (physical activity and dietary intake of saturated fat) may account for observed differences in CVD risk factors between type 2 diabetic and nondiabetic youth.     

Knowledge about cardiovascular risk factors among obese individuals.

BACKGROUND: Obesity is an important biological risk factor for cardiovascular disease (CVD). AIMS: The main aim of this study was to answer the question whether obese individuals differ from individuals with normal weight with regard to knowledge about risk factors for CVD. A further aim was to replicate previous findings that obese individuals are at higher risk of developing other biological risk factors for CVD. METHOD: Normal weights, BMI<25 kg/m(2) (n=385), and obese, BMI> or =30 kg/m(2) (n=159), individuals were identified from a screening program conducted among 50-year-old inhabitants of the County of V?stmanland, Sweden. Participants answered questions regarding their gender, level of education, and items relating to knowledge about cardiovascular risk factors. Total cholesterol and blood glucose levels, height, weight and blood pressure were measured. RESULTS: Obese individuals did not differ significantly from individuals with a normal weight regarding knowledge of cardiovascular risk factors when education was controlled for. Obesity and low level of education are associated with other risk factors for CVD such as high blood pressure and high serum cholesterol. CONCLUSION: Obese individuals are at an increased risk of developing other risk factors for CVD but are just as knowledgeable about risk factors for CVD as normal weighting individuals.     

The prevalence of the metabolic syndrome and its risk factors in a middle-aged Swedish population--mainly a function of overweight?

BACKGROUND: The prevalence of obesity, one risk factor for developing the metabolic syndrome (MS), has increased during the last decades. It has therefore been assumed that the prevalence of MS would also increase. AIMS: The aim was to analyse the prevalence of MS and its risk factors in a middle-aged Swedish population. METHODS: Data were obtained between 2003 and 2004 from a random population based sample of 502 men and 505 women, 45-69 years old. Measures of plasma glucose, serum lipids, blood pressure, weight, height, waist circumference and self-reported data concerning presence of disease, medication and lifestyle were obtained. RESULTS: The prevalence of MS was 14.8% among men and 15.3% among women, with an increase by age among women only, 10% to 25% (p=0.029). Among individuals with MS the most frequent risk factor was large waist circumference, present in 85% of men and 99% of women, followed by high blood pressure, high triglycerides, high glucose and HDL cholesterol (38% and 47% respectively). CONCLUSION: The prevalence of MS was 15%, increasing with age only among women. Overweight was a dominant characteristic, and only half of the individuals with MS had glucose/HDL cholesterol levels beyond defined cut points of the syndrome.