Metabolic Syndrome Increases Stroke Risk in Elderly

Metabolic syndrome in elderly subjects is associated with an increased risk for acute ischemic/nonembolic stroke, according to a new study. Dr. Haralampos J. Milionis from the University of Ioannina in Greece and colleagues investigated the relationship between the individual components of the metabolic syndrome and the risk for acute ischemic/nonembolic stroke among elderly subjects in northwestern Greece.

Metabolic syndrome was nearly 3 times more common among patients with acute ischemic/nonembolic stroke than among control subjects, the authors report, though both groups had similar serum total cholesterol, LDL cholesterol, and apolipoprotein B levels.

After adjusting for sex, age, body mass index, smoking habits, and the presence of hypertension, metabolic syndrome was associated with a 5.33-fold increased risk of stroke, the results indicate.]

Abdominal obesity, hypertension, high glucose levels, high triglyceride levels, and low HDL cholesterol levels were strong predictors of acute ischemic stroke in elderly subjects with metabolic syndrome, the researchers note, but the protective role of HDL cholesterol was attenuated in the presence of metabolic syndrome.

"Because the metabolic syndrome represents a condition associated with substantially high risk, pharmacological therapy to reduce cardiovascular risk would seem appropriate in most patients," the investigators write. "However, low-density lipoprotein cholesterol levels are not elevated in most patients with the metabolic syndrome, and there is no consensus on the appropriate low-density lipoprotein cholesterol target in the metabolic syndrome."

"It appears logical that targeted management should involve pharmacological treatment together with ‘therapeutic life style changes’ to reduce obesity, control hypertension and glycemia, and improve dyslipidemia," the authors conclude.
Stroke 2005;36:1372-1376.

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