Utility of metabolic syndrome as a risk enhancing factor in decision of statin use.

Abstract Background Statins effectively reduce risk for atherosclerotic cardiovascular disease (ASCVD) when 10-year risk is > 7.5%. In many patients at intermediate risk (7.5- Objective This study examines the scope of the metabolic syndrome, a risk enhancing factor, and its principal sequala, diabetes, in 26,796 US adults age 40-75 years from the NHANES survey data, 1999-2016. Methods The prevalence of metabolic syndrome without diabetes (MetS+) and of diabetes (DM+) were determined for 10-year risk categories estimated to be low ( > 20%). Data were weighted to account for complex study design. Results 90.4% of the population was free of ASCVD. In subjects projected to be at low risk by PCEs, MetS+ was present in 15.0% and 17.6% of women and men, respectively. MetS+ increased to 30.6% of women and 29.6% of men at intermediate risk, and to 21.5% of women and 32.2 % of men at high risk. In addition, DM+ was present in 6.1%/5.3% (F/M) of low risk individuals, 20.1%/14.8% (F/M) of intermediate risk subjects, and 44.3%/39.4% (F/M) of high-risk persons. Prevalence of both MetS+ and DM+ rose progressively with age in women and men. Conclusions MetS+ and DM+ are common multiplex risk factors that predispose to higher lifetime risk and support statin therapy in patients at intermediate and high risk.