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(Stroke. 2008;39:e164.)
© 2008 American Heart Association, Inc.

Letters to the Editor

Response to Letter by Sheikh

Cardiology Unit/Department of Medicine, Kuopio University Hospital, Kuopio, Finland

Markku Laakso, MD, PhD

Department of Medicine, Kuopio University Hospital, Kuopio, Finland

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Response:

We thank Dr Kazim Sheikh for his remarks on our article published in Stroke.¹ Dr Sheikh raises an important question as to why it is necessary to combine several cardiovascular risk factors into a syndrome called the metabolic syndrome (MetS) and determine its association with stroke. The concept of the MetS is based on the fact that certain cardiovascular risk factors cluster in individuals.^2,3 The presence of this clustering approximately doubles the risk of atherosclerotic vascular disease over 5 to 10 years.² The 6 definitions of the Mets have been designed by expert panels to provide clinicians with a tool to identify individuals with an increased risk for diabetes and cardiovascular disease.⁴ Most previous studies on the MetS, however, have used modified definitions other than proposed, and diabetic subjects have not been definitively excluded. Additional prospective data with hard cardiovascular end points and a comprehensive set of morphometric and metabolic markers was warranted to sort the key predictors of risk.⁵ Conseqeuntly, we investigated whether the MetS and its single components, defined by the 6 originally proposed criteria, predicted stroke in an elderly cohort of 991 nondiabetic Finnish subjects during a 14-year follow-up.¹ The MetS defined by the 6 current criteria except for the ACE definition predicted stroke with hazard ratios (HRs) of 1.49 to 1.80 in nondiabetic subjects without coronary heart disease at baseline, verifying that the Mets criteria, indeed, are valuable in estimating the risk for stroke. We could also identify 3 single components of the MetS . . . [Full Text of this Article]