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. |