By Michelle Rizzo

NEW YORK (Reuters Health) - A new study shows that people with the so-called metabolic syndrome have a significantly higher risk of suffering ischemic strokes, which are caused by a blood clot in the vessels supplying the brain and account of the large majority of stroke cases.

Metabolic syndrome refers to a cluster of risk factors for diabetes and heart disease -- including abdominal obesity, high blood pressure, high blood sugar, low levels of "good" HDL cholesterol and high triglycerides (another type of blood fat). The syndrome is typically diagnosed when a person has three or more of these conditions.

In the new study, there was a clear dose-response relationship between the number of metabolic syndrome components and stroke risk, with the highest risk of stroke associated with metabolic syndrome in people with either elevated blood pressure or elevated blood sugar in the risk-factor cluster.

"Considering that the developed countries are experiencing an obesity epidemic, and that stroke is the leading course of disability and the third leading course of death in the U.S. and other developed countries, our findings suggest the need to target metabolic syndrome, especially metabolic syndrome with these two highest risk components -- elevated blood pressure or elevated fasting glucose in the clusters -- in order to reduce the public health, individual, and family burden of stroke," Dr. Duanping Liao and co-investigator Sol Rodriguez-Colon noted in an email communication with Reuters Health.

The investigators analyzed data on 14,993 stroke-free adults followed over 9 years for stroke as part of the Atherosclerosis Risk in Communities Study. The participants' average age was 54 years, 26 percent were black, and 55 percent were females. At the outset, 39 percent of participants had metabolic syndrome.

During follow up, 210 people suffered stroke and 188 of these strokes were classified as ischemic in nature.

Liao, from Pennsylvania State University College of Medicine, Hershey, and colleagues observed a greater than twofold increased risk of stroke among men and women with metabolic syndrome compared to those without.

Compared to people without any component of metabolic syndrome, the risk of stroke increased with the number of metabolic syndrome components present.

The greatest risk of developing stroke was found in individuals with metabolic syndrome that had either high blood pressure or high blood sugar.

"These findings provide a better understanding of the relationship between metabolic syndrome and stroke in the U.S. population," Liao and Rodriguez-Colon noted.

SOURCE: Stroke, January 2009.

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