Gender differences in the prevalence of metabolic syndrome in 50-year-old Swedish men and women with hypertension born in 1953

Abstract

To investigate potential gender differences in the role of hypertension as a risk factor for metabolic syndrome (MetS) we used a random population sample of 50-year-old men (n ¼ 595) and women (n ¼ 667; all born in 1953) who were examined in 2003 --2004. Systolic (SBP) and diastolic (DBP) blood pressure values were dichotomized at X140 mm Hg and X90 mm Hg, respectively. MetS was defined using NCEP (National Cholesterol Education Programme) and IDF (International Diabetes Federation) criteria. MetS was more prevalent in men than in women (NCEP 16% versus 10%, P ¼ 0.003; IDF 26% versus 16%, P ¼ 0.000) and systolic hypertension was more common in men than in women (high SBP 24% versus 18%, P ¼ 0.003; high DBP 29% versus 24%, P ¼ 0.074). Women with high SBP had about a seven-fold increased NCEP risk compared with normotensive women (odds ratio (OR) 6.91, confidence interval (CI) 2.90 --16.42), whereas high SBP in men was associated with about a threefold increased NCEP risk (OR 2.72, CI 1.69 --4.38). A similar pattern was observed for the IDF criterion of MetS. All interaction terms (sex  hypertension) were significant at Po0.01. At middle age, despite that fewer women had hypertension or MetS than men, hypertension carries a relatively greater risk for MetS in women than in men. Keywords: systolic blood pressure; diastolic blood pressure; metabolic syndrome; gender INTRODUCTION Hypertension is a highly prevalent condition and a major contributor to the development of cardiovascular disease (CVD) in both genders. 1 --3 Hypertension frequently occurs in conjunction with other cardiometabolic risk factors and clustering of certain risk factors in an individual constitutes the condition now referred to as metabolic syndrome (MetS), which includes high blood pressure (BP), glucose intolerance, dyslipidaemia and abdominal obesity. 4,5 Although there is a debate surrounding the concept of MetS, 6 --8 the syndrome and its components are recognized as strong predictors of CVD in hypertensive men and women. 2,9 Therefore, recent clinical guidelines for the treatment of hypertension stress the importance of identification and appropriate management of multiple metabolic risk factors in hypertensive patients. 10 Although hypertension is a major predictor of CVD in both men and women, there is gender-specific variability in the outcome of cardiovascular-related events associated with high BP. 11,12 In a comparison of the CVD risk associated with systolic BP (SBP) measurements a large cohort of men and women followed-up for 11.2 years from the general population of 11 countries demonstrated that the absolute risk of all fatal and non-fatal cardiovascular events is lower in women than in men. 11 However, the relative risk of all cardiovascular events associated with an increase in SBP is steeper in women than in men. 11 In the Framingham study hypertension is reported to account for 39% of coronary heart failure events in men and 59% in women. 12 Given the gender-specific influence of hypertension on cardiovascular-

Adherence to the Nordic Nutrition Recommendations in a Nordic population with metabolic syndrome: high salt consumption and low dietary fibre intake (The SYSDIET study)

“…The gender division in the current study is about one-third males and two-thirds females. In recent Finnish and Swedish population-based studies, the MetS prevalence was somewhat higher in men than women (9, 70). For better representativeness of our study population, a higher ratio of men would have been preferable.…”

Prevalence of Metabolic Syndrome: Association with Risk Factors and Cardiovascular Complications in an Urban Population

“…These findings were very similar to present study. In a Swedish study, high BP was the most common component in both sexes, followed by high waist circumference among women and changes in TG levels among men [53]. In China, the prevalence of individual components of MS was in order: high BP, TG, plasma glucose, central obesity and HDL-c in men and high BP, central obesity, TG, HDL-c and plasma glucose in women [54].…”

Impact of gender and menopausal status on metabolic parameters in chronic hepatitis C infection

“…Nevertheless, similar to the general population and that observed with SSPG, nonwhite race (predominantly African Americans and Latinos) was associated with metabolic syndrome in this HCV cohort . With respect to gender, studies have shown that in the general population, men have earlier onset and increased rates of metabolic syndrome than women , a difference that decreases sharply after women reach menopause . Moreover, a recent study of the Third National Health and Nutrition Survey in the United States showed that abdominal obesity was the dominant component of metabolic syndrome in women, whereas risk factor combinations were more variable in men .…”