Study highlights:

• Metabolic syndrome is associated with an increase in risk of future symptomatic peripheral artery disease (PAD) in women.
• The relationship between metabolic syndrome and PAD in women was partially explained by heightened inflammation and vascular endothelial dysfunction.

DALLAS, Sept. 8, 2009 — Women with metabolic syndrome have more than two-thirds higher risk of developing symptomatic peripheral artery disease than women who don’t have the syndrome, according to new research reported in Circulation: Journal of the American Heart Association.

Peripheral artery disease (PAD) affects the arteries outside the heart and brain, most commonly those in the pelvis and legs. PAD affects about 8 million Americans, grows more common with age and is associated with an elevated risk of heart disease or stroke.

Researchers assessed whether 27,111 subjects in the Women’s Health Study had any of the traits that define metabolic syndrome, a collection of cardiovascular risk factors including
• abdominal obesity,
• high blood pressure,
• low HDL-cholesterol,
• triglycerides, and
• abnormal glucose metabolism.

Women with metabolic syndrome (defined as having three or more of the traits) had a 62 percent increased risk of future PAD compared to those without it.

When they assessed the per-trait risk for PAD, the researchers found a roughly 20 percent increased risk for PAD for each additional syndrome trait.

Furthermore, two inflammation markers — high sensitivity C-reactive protein and soluble intercellular adhesion molecule-1 — were strongly tied to metabolic syndrome and PAD. How inflammation along with the metabolic syndrome causes PAD is unclear, said Aruna D. Pradhan, M.D., M.P.H., senior author of the study and assistant professor at Brigham and Women’s Hospital in Boston, Mass.

This study is one of few to examine whether women with this risk factor clustering are at higher risk for developing lower extremity artery disease; most prior reports studied coronary disease or stroke. It provides sorely needed information to help identify who is at risk.

Co-authors are David Conen, M.D., M.P.H.; Kathryn M. Rexrode, M.D., M.P.H.; Mark A. Creager, M.D. and Paul M. Ridker, M.D., M.P.H. Author disclosures are on the manuscript.

The National Heart, Lung, and Blood Institute partially funded the study. Other funding sources include the National Cancer Institute, the Donald W. Reynolds Foundation, and the Swiss National Science Foundation.

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NR09 – 1110 (Circ/Pradhan)