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(Stroke. 2007;38:893.)
© 2007 American Heart Association, Inc.

Original Contributions

The Metabolic Syndrome and the Carotid Artery Structure in Noninstitutionalized Elderly Subjects

The Three-City Study

Jean-Philippe Empana, MD, PhD; Mahmoud Zureik, MD, PhD; Jerome Gariepy, MD; Dominique Courbon, MSc; Jean Francois Dartigues, MD, PhD; Karen Ritchie, PhD; Christophe Tzourio, MD, PhD; Annick Alperovitch, MD, MSc Pierre Ducimetiere, PhD

From INSERM U780 (J.P.E., P.D.), Cardiovascular Team, Paris XI University, Paul Brousse Hospital, Villejuif, France; INSERM U508 (M.Z., D.C.), Institut Pasteur de Lille, Lille II University, Lille, France; Center of Preventive Cardiovascular Medicine (J. G.), Broussais Hospital, Paris, France; INSERM U593 (J.F.D.), Bordeaux 2 University, Bordeaux, France; INSERM E0361 (K.R.), La Colombiere Hospital, Montpellier, France; INSERM U708 (C.T., A.A.), Pierre Marie Curie Paris 5 University, La Salpetriere Hospital, Paris, France.

Correspondence to J. P. Empana, INSERM U780, Cardiovascular Team, Hôpital Paul Brousse, 16 Ave Paul Vaillant Couturier, 94807 Villejuif cedex, France. E-mail empana{at}vjf.inserm.fr

Background and Purpose— In contrast to the young adult population, limited data are presently available regarding the epidemiology of the metabolic syndrome (MetS) and its relationship with cardiovascular disease risk in the elderly. We have investigated the frequency of the MetS and its association with the carotid artery structure in an elderly free-living population.

Methods— The study population consists of 5585 French noninstitutionalized elderly men and women aged 65 to 85 years, free of diabetes, who participated in the multicenter Three City Study and who underwent ultrasound examination of the carotid arteries at baseline examination between March 1999 and March 2001. The MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria.

Results— The MetS was present in 12.1% of the study participants, with slightly higher rates in men. Subjects with the MetS had higher frequency of carotid plaques (odds ratio, 1.30; 95% CI, 1.09 to 1.55), higher intima-media thickness of the common carotid artery (odds ratio, 1.81; 95% CI, 1.37 to 2.41), and higher lumen diameter (odds ratio, 2.17; 95% CI, 1.61 to 2.94) (upper quintiles) after adjustment for other cardiovascular risk factors. This association was observed in both genders and in subjects without prevalent cardiovascular disease. Elevated blood pressure as defined in the MetS was the main determinant of the relations between the MetS and the carotid parameters, especially the lumen diameter.

Conclusions— The present data suggest that noninstitutionalized elderly subjects with the MetS have altered structure of the carotid arteries.

Key Words: atherosclerosis • carotid artery abnormalities • elderly • epidemiology • metabolic syndrome

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