Author + information
- Received December 17, 2012
- Revision received April 5, 2013
- Accepted May 6, 2013
- Published online August 20, 2013.
- Hiram Beltrán-Sánchez, PhD∗∗ (, )
- Michael O. Harhay, MPH†,
- Meera M. Harhay, MD‡ and
- Sean McElligott, MS†,§
- ∗Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts
- †Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- ‡Renal Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- §Department of Health Care Management and Economics, Wharton School of the University of Pennsylvania, Philadelphia, Pennsylvania
Reprint requests and correspondence:
Dr. Hiram Beltrán-Sánchez, Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, Massachusetts 01238.
Objectives This study sought to characterize the prevalence of metabolic syndrome (MetS), its 5 components, and their pharmacological treatment in U.S. adults by sex and race/ethnicity over time.
Background MetS is a constellation of clinical risk factors for cardiovascular disease, stroke, kidney disease, and type 2 diabetes mellitus.
Methods Prevalence estimates were estimated in adults (≥20 years of age) from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 (in 2-year survey waves). The biological thresholds, defined by the 2009 Joint Scientific Statement, were: 1) waist circumference ≥102 cm (males adults) and ≥88 cm (female adults); 2) fasting plasma glucose ≥100 mg/dl; 3) blood pressure of ≧130/85 mm Hg; 4) triglycerides ≥150 mg/dl; and 5) high-density lipoprotein-cholesterol (HDL-C) <40 mg/dl (male adults) and <50 mg/dl (female adults). Prescription drug use was estimated for lipid-modifying agents, anti-hypertensives, and anti-hyperglycemic medications.
Results From 1999 and 2000 to 2009 and 2010, the age-adjusted prevalence of MetS (based on biologic thresholds) decreased from 25.5% (95% confidence interval [CI]: 22.5% to 28.6%) to 22.9% (95% CI: 20.3% to 25.5%). During this period, hypertriglyceridemia prevalence decreased (33.5% to 24.3%), as did elevated blood pressure (32.3% to 24.0%). The prevalence of hyperglycemia increased (12.9% to 19.9%), as did elevated waist circumference (45.4% to 56.1%). These trends varied considerably by sex and race/ethnicity. Decreases in elevated blood pressure, suboptimal triglycerides, and high-density lipoprotein-cholesterol prevalence have corresponded with increases in anti-hypertensive and lipid-modifying drugs, respectively.
Conclusions The increasing prevalence of abdominal obesity, particularly among female adults, highlights the urgency of addressing abdominal obesity as a healthcare priority. The use of therapies for MetS components aligns with favorable trends in their prevalence.
Dr. Harhay has received training grants (5T32DK007006-38 and F32DK096758-01) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Dr. Beltrán-Sánchez has received a training grant (T32AG00037) from the National Institute on Aging (NIA). All other authors have reported that that they have no relationshops relevant to the contents of this paper to disclose. Drs. Beltrán-Sánchez and Harhay contributed equally to this work.
- Received December 17, 2012.
- Revision received April 5, 2013.
- Accepted May 6, 2013.
- American College of Cardiology Foundation