BMJ  2006;332:1036 (29 April), doi:10.1136/bmj.332.7548.1036-a

Letter

Predictive value of metabolic syndrome is not clear

The first 100% of the full text of this article appears below.

EDITOR—Sundstrom et al claim that in their cohort of 50 year old men the identification of the metabolic syndrome (as defined) added to the prediction of total and cardiovascular mortality obtained from classic risk factors.1

However, the electronic version of the article clearly shows that this superiority emerges only after about 15 years of follow-up. As most guidelines for therapeutic intervention are predicated on 10 year risk, the observation does not have pragmatic value.

Furthermore, the comparatively poor performance of the classic risk factors seems to be due to the unusually low predictive power of total cholesterol in this cohort, which suggests that the result would not be generally applicable.

Richard J Jarrett, emeritus professor of clinical epidemiology, University of London

London SE26 4OA graverjarrett@waitrose.com

Competing interests: None declared.

  1. Sundström J, Risérus U, Byberg L, Zethelius B, Lithell H, Lind L. Clinical value of the metabolic syndrome for long term prediction of total and cardiovascular mortality: prospective, population based cohort study. BMJ 2006;332: 878-82. (15 April.)[Abstract/Free Full Text]

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Relevant Article

Clinical value of the metabolic syndrome for long term prediction of total and cardiovascular mortality: prospective, population based cohort study
Johan Sundström, Ulf Risérus, Liisa Byberg, Björn Zethelius, Hans Lithell, and Lars Lind
BMJ 2006 332: 878-882. [Abstract] [Full Text] [PDF]

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