{"id":"066a0d94676a","type":"article","url":"https://hartvaat.nl/2026/04/24/bij-metabool-syndroom-zonder-diabetes-of-hypertensie-bloeddruk-en-triglyceriden-/","title":"Bij metabool syndroom zonder diabetes of hypertensie: bloeddruk en triglyceriden zijn de sleutel","title_en":"","category":"cholesterol","category_label":"Cholesterol","professions":["huisarts","internist"],"tags":["bloeddrukbehandeling","diabetes-en-hart","diabetes-type-2","dyslipidemie","ezetimibe","lipidenverlaging"],"journal":"BMJ open","doi":"10.1136/bmjopen-2025-105379","source_url":"https://doi.org/10.1136/bmjopen-2025-105379","authors":["Per Nordin","Ulf Lindblad","Kristin Ottarsdottir","Bledar Daka","Margareta Hellgren"],"significance":5,"published":"2026-05-10","source_date":"2026-04-24","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/preventie/preventie-bij-diabetes/"],"congress":"","summary_en":"The Skaraborg cohort (Sweden) followed 2,328 individuals without diabetes or hypertension at baseline (2002-2005, follow-up to 2011). The NCEP-defined metabolic syndrome predicted cardiovascular events (HR 2.4); IDF criteria did not. Blood pressure (HR 1.77) and triglycerides (HR 2.05) were the strongest individual predictors. Combining BP ≥125/80 mmHg with triglycerides ≥1.5 mmol/L matched the full MetS for prediction (HR 2.1; sensitivity 32.5%; NNE 7.1). Lowering the triglyceride cut-off to ≥1.2 mmol/L raised sensitivity to 44.9%. Practical: pay attention to borderline blood pressure and then measure triglycerides.","created":"2026-07-03T10:32:53Z","updated":"2026-07-03T18:39:32Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Het Skaraborg-cohort (Zweden) volgde 2.328 personen zonder diabetes of hypertensie (2002-2005, follow-up tot 2011). Het metabool syndroom volgens NCEP-criteria voorspelde cardiovasculaire events (HR 2,4); IDF-criteria niet. Bloeddruk (HR 1,77) en triglyceriden (HR 2,05) waren de sterkste afzonderlijke voorspellers. Combinatie van bloeddruk ≥125/80 mmHg met triglyceriden ≥1,5 mmol/L gaf even goede predictie als het volledige metabool syndroom (HR 2,1; sensitiviteit 32,5%; NNE 7,1). Lagere triglyceriden-cutoff (≥1,2 mmol/L) verhoogt sensitiviteit naar 44,9%. Praktisch advies: let op patiënten met grenswaarde-bloeddruk en meet dan triglyceriden.","abstract_original":"OBJECTIVES: To examine the metabolic syndrome (MetS) and its components as risk factors for a cardiovascular (CV) event, in individuals without diabetes and/or hypertension, and to explore which of the risk factors are the most predictive for cardiovascular disease (CVD) and whether the assessment of risk could be simplified. DESIGN: A longitudinal, cross-sectional study. SETTING: A randomly selected population. PARTICIPANTS: In 2002-2005, 2816 randomly selected residents of Skaraborg, Sweden, underwent physical examinations and blood tests as part of the Skaraborg Project. Exclusion of individuals with diabetes mellitus and/or hypertension at baseline left 2328 persons for analyses. OUTCOME MEASURES: CV events were assessed in 2011 using national Swedish registers. RESULTS: A total of 293 (13%) were defined as having the MetS according to the National Cholesterol Education Programme (NCEP) and 292 according to the International Diabetes Federation (IDF) definition, whereof 27 had a CV event after a mean follow-up time of 9.7 years. The MetS according to NCEP was significantly predictive of a CVD with an HR 2.4 (95% CI 1.4 to 3.9) but not according to the IDF definition. Blood pressure was significantly predictive according to both definitions (HR 1.77, 95% CI 1.06 to 2.97). Also, triglycerides (Tg) were significantly predictive for a CV event (HR 2.05, 95% CI 1.17 to 3.59). Neither waist circumference, high-density lipoprotein nor fasting plasma glucose was predictive for a CV event. Combining a blood pressure ≥125/≥80 mm Hg with Tg ≥1.5 mmol/L was predictive for CVD (HR 2.1, 95% CI 1.3 to 3.6) with a sensitivity of 32.5% and numbers needed to examine (NNE) 7.1. Lowering the cut-off for Tg to ≥1.2 mmol/L (HR 2.1, 95% CI 1.3 to 3.4) increased sensitivity to 44.9% and NNE became 8. CONCLUSIONS: Using blood pressure combined with Tg was shown to be an equally good predictor for CVD as the complete MetS in individuals without diagnosed diabetes or hypertension. Therefore, healthcare personnel should pay attention to individuals with a borderline blood pressure, and if equivalent to or equal to 125/85, continue with measuring Tg for a discussion concerning lifestyle."}