Metabolic syndrome and its components predict all-cause and cardiovascular mortality in elderly: the Pro. V.A. study

Objectives. The objective of this study was to explore the association of metabolic syndrome and each of its components with all-cause and cardiovascular mortality in a general Italian elderly population. Methods. Metabolic syndrome, diagnosed by National Cholesterol Education Program Adult Treatment Panel III, all-cause and cardiovascular mortality were evaluated in 2910 subjects aged 65 years and older of the Progetto Veneto Anziani (Pro. V.A.) Study during a mean follow-up time of 4.4 years. Results. After multivariable adjustment, metabolic syndrome was associated with increased all-cause mortality in all subjects (HR = 1.41, 95% CI 1.16-1.72, p = 0.001), among men (HR = 1.42, 95% CI 1.06-1.89, p = 0.017), and women (HR = 1.47, 95% CI 1.13-1.91, p = 0.004). High glucose in all subjects and in women, and low HDL cholesterol in women were significant predictors of all-cause mortality, even independently from the interactions of different metabolic syndrome components. After multivariable adjustment, metabolic syndrome was also associated with increased cardiovascular mortality in all subjects (HR = 1.60, 95% CI 1.17-2.19, p = 0.003), among men (HR = 1.66, 95% CI 1.00-2.76, p = 0.051), and women (HR = 1.60, 95% CI 1.06-2.33, p = 0.025). High glucose and low HDL cholesterol among women predicted higher cardiovascular mortality. Conclusions. In this general Italian elderly population, among metabolic syndrome components all-cause mortality is better predicted by high glucose in all subjects and in women, and by low HDL cholesterol in women, while cardiovascular mortality is better predicted by high glucose, and low HDL cholesterol in women.