Ncep Atp

(1) HYPERTENSION BP> 130/85 or drug treatment for elevated blood pressure

(2) DYSLIPIDEMIA Plasma Triglycerides> 150 mg/dL or drug treatment for elevated triglycerides HDL cholesterok40 mg/dL

(0.9 mmol/L) in men and k50 mg/dL (1.1 mmol/L) in women. Or drug treatment for reduced HDL-C

(3) OBESITY Waist circumference >40 in(102cm) in males and >35 in (88 cm) in females

(4) Fasting blood sugar > 100 mg/dL or drug treatment

NCEP requires any THREE of the above criteria to be met.

Abbreviations: WHO, World Health Organization; NCEP ATP III, National Cholesterol Education Program, Adult Treatment Panel; IDF, International Diabetes Federation Ethnic specific values for waist circumference. Source: Refs. 128-130.

age 50, presence of the metabolic syndrome as defined in the NCEP significantly predicted total and CV mortality (Cox proportional hazard ratios 1.36, 95% confidence interval 1.17 to 1.58; and 1.59, 1.29 to 1.95, respectively). The metabolic syndrome added prognostic information to that of the established risk factors for CVD (likelihood ratio tests, P k 0.0001 for both outcomes). Similar results were obtained in a sub sample without diabetes or manifest CVD (19). These studies confirm that components of the syndrome are present for several years before the onset of type 2 diabetes and support the adage that the "clock for coronary heart disease start ticking before the onset of clinical diabetes" (17).

Though it is generally agreed that the clustered risk factors taken in combination are associated with an elevated risk of CVD, IRS is not without controversy and debate as to how it should be employed clinically. More recently, the metabolic syndrome as defined by ATP III was shown to be significantly predictive of vascular events after adjustment for type 2 diabetes but was dependent on the lipid traits of high triglycerides and low HDL cholesterol (20).

Waist circumference

Country/Ethnic group Male Female

Europids > 94cm > 80cm

Chinese > 90cm > 80cm

Ethnic South and Central Americans Use South Asian recommendations until more specific data are available

Sub-Saharan Africans Use European data

Eastern Mediterranean and Middle Eastern (Arab) populations Use European data

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