Original article Metabolic Syndrome in Spain: Prevalence and Coronary Risk Associated With Harmonized Definition and WHO Proposal. DARIOS Study Daniel Ferna ´ ndez-Berge ´s, a, * Antonio Cabrera de Leo ´ n, b,c He ´ ctor Sanz, d Roberto Elosua, d,e Marı ´a J. Guembe, f,g Maite Alzamora, h,i Toma ´s Vega-Alonso, j Francisco J. Fe ´ lix-Redondo, a,k Honorato Ortiz-Marro ´ n, l Fernando Rigo, m Carmen Lama, n,o Diana Gavrila, e,p Antonio Segura-Fragoso, q Luis Lozano, a and Jaume Marrugat d a Unidad de Investigacio ´n Don Benito Villanueva, Programa de Investigacio ´n en Enfermedades Cardiovasculares (PERICLES), Fundesalud, Gerencia A ´ rea Sanitaria Don Benito-Villanueva, Badajoz, Spain b Unidad de Investigacio ´n de Atencio ´n Primaria, Hospital Universitario Nuestra Sen ˜ora de Candelaria, Santa Cruz de Tenerife, Spain c A ´ rea de Medicina Preventiva y Salud Pu ´blica, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, Spain d Grupo de Epidemiologı´a y Gene ´tica Cardiovascular, Programa de Investigacio ´n en Procesos Inflamatorios y Cardiovasculares, Instituto Municipal de Investigacio ´n Me ´dica, Barcelona, Spain e CIBER Epidemiologı´a y Salud Pu ´blica (CIBERESP), Spain f Servicio de Docencia y Desarrollo Sanitarios, Departamento de Salud, Gobierno de Navarra, Pamplona, Navarra, Spain g Grupo de Investigacio ´n Riesgo Vascular en Navarra (RIVANA), Departamento de Salud, Gobierno de Navarra, Pamplona, Navarra, Spain h Centre de Salud Riu Nord-Riu Sud, Institut Catala ` de la Salut, Santa Coloma de Gramenet, Barcelona, Spain i USR Metropolitana Nord, ICS-IDIAP Jordi Gol, Mataro ´, Barcelona, Spain j Direccio ´n General de Salud Pu ´blica e Investigacio ´n, Desarrollo e Innovacio ´n, Consejerı´a de Sanidad de la Junta de Castilla y Leo ´n, Valladolid, Spain k Centro de Salud Villanueva Norte, Servicio Extremen ˜o de Salud, Villanueva de la Serena, Badajoz, Spain l Servicio de Epidemiologı´a, Subdireccio ´n General de Promocio ´n de la Salud y Prevencio ´n, Servicio Madrilen ˜o de Salud, Madrid, Spain m Grupo Cardiovascular de Baleares de redIAPP, UB Genova, IB-Salut, Palma de Mallorca, Baleares, Spain n Gestio ´n y Evaluacio ´n, Direccio ´n General de Asistencia Sanitaria, Servicio Andaluz de Salud, Spain o CIBER de Fisiopatologı´a de la Obesidad y la Nutricio ´n, Instituto de Salud Carlos III, Madrid, Spain p Servicio de Epidemiologı´a, Consejerı´a de Sanidad y Consumo de la Regio ´n de Murcia, Murcia, Spain q Servicio de Investigacio ´n, Instituto de Ciencias de la Salud de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain Rev Esp Cardiol. 2012;65(3):241–248 Article history: Received 29 June 2011 Accepted 22 October 2011 Available online 3 February 2012 Keywords: Metabolic syndrome Diabetes mellitus Cardiovascular disease Risk scores A B S T R A C T Introduction and objectives: To update the prevalence of metabolic syndrome and associated coronary risk in Spain, using the harmonized definition and the new World Health Organization proposal (metabolic premorbid syndrome), which excludes diabetes mellitus and cardiovascular disease. Methods: Individual data pooled analysis study of 24 670 individuals from 10 autonomous communities aged 35 to 74 years. Coronary risk was estimated using the REGICOR function. Results: Prevalence of metabolic syndrome was 31% (women 29% [95% confidence interval, 25%-33%], men 32% [95% confidence interval, 29%-35%]). High blood glucose (P=.019) and triglycerides (P<.001) were more frequent in men with metabolic syndrome, but abdominal obesity (P<.001) and low high- density lipoprotein cholesterol (P=.001) predominated in women. Individuals with metabolic syndrome showed moderate coronary risk (8% men, 5% women), although values were higher (P<.001) than in the population without the syndrome (4% men, 2% women). Women and men with metabolic syndrome had 2.5 and 2 times higher levels of coronary risk, respectively (P<.001). Prevalence of metabolic premorbid syndrome was 24% and the increase in coronary risk was also proportionately larger in women than in men (2 vs 1.5, respectively; P<.001). Conclusions: Prevalence of metabolic syndrome is 31%; metabolic premorbid syndrome lowers this prevalence to 24% and delimits the population for primary prevention. The increase in coronary risk is proportionally larger in women, in both metabolic syndrome and metabolic premorbid syndrome. ß 2011 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L. All rights reserved. * Corresponding author: Unidad de Investigacio ´n Don Benito Villanueva, Programa de Investigacio ´n en Enfermedades Cardiovasculares (PERICLES), Fundesalud, Gerencia A ´ rea Sanitaria Don Benito-Villanueva, Plaza de Conquistadores 49-50, 06700 Villanueva de la Serena, Badajoz, Spain. E-mail address: polonibo@gmail.com (D. Ferna ´ ndez-Berge ´ s). 1885-5857/$ – see front matter ß 2011 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L. All rights reserved. doi:10.1016/j.rec.2011.10.017