ORLANDO, FLA. — Middle-aged women should routinely be assessed for metabolic syndrome, Ana M. Schaper, Ph.D., said at an international conference on women, heart disease, and stroke.
In a chart review including 147 women under 65 years who were treated for MI in a rural midwestern community, Dr. Schaper found that 113 (77%) had no history of coronary artery disease (CAD), but many had risk factors: a history of smoking in 70%, high blood pressure in 63%, a family history of CAD in 52%, and obesity or overweight in 70%.
Sufficient data were available for 80 of the women with no history of CAD to allow risk stratification based on National Cholesterol Education Program guidelines. Of these women, only 10% would have qualified for medical management under the guidelines, and only 18% would have qualified for therapeutic lifestyle changes, but 49% had metabolic syndrome, said Dr. Schaper of Gundersen Lutheran Medical Foundation, La Crosse, Wis., in a news conference at the meeting.
Of the 135 patients who survived their initial hospitalization, 54 were readmitted within a year for chest pain, myocardial infarction, or for a revascularization procedure. All women who were discharged on an ACE inhibitor or angiotensin receptor blocker, and lipid therapy, and 90% of those discharged on a β-blocker, remained on their medications at 1-year follow-up.
At that time, total- and LDL-cholesterol levels were lower, and HDL-cholesterol levels were higher. Triglyceride levels were unchanged, Dr. Schaper said.
The findings suggest that all components of metabolic syndrome in younger women should be identified and treated aggressively, she said.