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Ischemic stroke occurs as a result of varying etiologies but commonly involves atherothrombosis of large or small cerebral vessels. The risk factors for both small and large vessel disease overlap and include diabetes, hypertension, hyperlipidemia, and smoking. One increasingly recognized vascular risk factor is metabolic syndrome, which represents a clustering of several of atherogenic factors. The criteria for metabolic syndrome include three or more of the following: abdominal obesity, elevated triglycerides (≫150 mg/dL), elevated fasting glucose (≫110 mg/dL), low high-density lipoprotein cholesterol (<40 mg/dL for men, <50 mg/dL for women), and hypertension (systolic blood pressure <130 mm Hg, diastolic blood pressure >85 mm Hg, or use of antihypertensive medication).1 Whether this syndrome preferentially affects large or small vessel strokes is uncertain, but new data are accumulating.
Several recent studies have shown that metabolic syndrome is a significant risk factor for vascular disease and for stroke in particular. Data from the Third National Health and Nutrition Examination Survey indicate that …
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