Background: Cardiovascular risk (CV) factors associated with the metabolic syndrome (MetS)
may vary in different populations. In some, hypertension may be the major determinant, in others are low
high-density lipoprotein cholesterol (HDL-C), high triglycerides, or another component.
Subjects and Methods: Subjects included in this analysis were identified in 2006, among those attending
the Lipid Clinic of the Niguarda Hospital, and followed up through to 2013. Patient characteristics (including
the occurrence of CV events) were obtained from electronic medical records. MetS was diagnosed
according to the American Heart Association/National Heart, Lung and Blood Institute
(AHA/NHLBI) guidelines. The carotid intima media thickness (cIMT) was also followed in these patients
over the years.
Results: After 7 years a total of 858 subjects had a complete follow-up; 271 of those had MetS. Patients
developing a CV event showed elevated baseline cIMT (e.g. cIMTmax ≥ 2.4 mm in males and ≥ 2.2 mm in
females); moreover the cIMT in MetS patients was higher at baseline and the rise over 7 years was larger
compared with patients without MetS. By examining each body variable for MetS we found that a waist
to height ratio (WHtR) ≥ 0.5 was present in nearly all subjects with a CV event.
Conclusion: The follow-up data of a series of Italian patients with and without MetS, clearly indicates
that the former have a raised cIMT and their arterial IMT progression is greater and the presence of a
larger WHtR is apparently linked to a higher incidence of CV events.