A new study suggests that individuals with a grouping of metabolic risk factors are more likely to develop heart failure (HF) than those without metabolic syndrome (MS), irrespective of weight.

Researchers at Athens University Medical School (Greece) conducted a study involving 550 individuals (without diabetes or baseline macrovascular complications) that were studied during a median follow-up of six years. Participants were classified by the presence (271 participants) or absence (279 participants) of MS, as well as by body mass index (BMI); MS was diagnosed using the US National Cholesterol Education Program Adult Treatment Panel III criteria. Left ventricular functional capacity, myocardial structure, and performance were assessed echocardiographically.

The researchers found that BMI was not associated with increased HF risk, but the presence of MS conferred more than double the risk for HF. From the individual components of MS, impaired fasting glucose, high blood pressure, low high-density lipoprotein (HDL) cholesterol, and central obesity were all associated with increased HF risk. Factors commonly associated with MS such as insulin resistance and inflammation--identified by high-sensitivity C-reactive protein (CRP) and microalbuminuria--were also independently associated with HF incidence. The study was published in the September 20, 2011, issue of the Journal of the American College of Cardiology.

“Normal-weight individuals with that grouping of metabolic risk factors were 2.33 times more likely to develop heart failure over six years than those without metabolic syndrome,” concluded lead author Christina Voulgari, MD, PhD, and colleagues of the department of cardiology. “In contrast to normal weight insulin-resistant individuals, metabolically healthy obese individuals show decreased HF risk.”

Metabolic syndrome is a name for a group of risk factors that occur together and increase the risk for coronary artery disease, stroke, and type 2 diabetes mellitus. The two most important risk factors for metabolic syndrome are extra weight around the middle and upper parts of the body (central obesity), and insulin resistance, in which the body cannot use insulin effectively. Any two of the following conditions must also be present; raised triglycerides, reduced HDL cholesterol, and raised blood pressure.

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