Cardiovascular risk factors and metabolic syndrome in alcohol- and nicotine-dependent men and women.

BACKGROUND AND RESEARCH OBJECTIVE

Cardiovascular disease (CVD) is a leading cause of mortality among alcohol-dependent people; however, minimal data exist on the CVD risk factor profile in this high-risk population. The purpose of this study was to examine the prevalence and clustering of traditional and novel CVD risk factors, including components of the metabolic syndrome, in nicotine- and alcohol-dependent adults.

SUBJECTS AND METHODS

Participants (n = 46; 61% men; 87% white), who were a consecutive series of eligible adults (19-56 years of age; mean, 34.8 +/- 1.4 years; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-classified alcoholic; abstinent for <or=7 days), were assessed on entry to a residential drug treatment facility. Cardiovascular disease risk factors were measured using standardized protocols and interview-administered, self-report inventories adapted from epidemiological studies. Dyslipidemia and metabolic syndrome were identified using Adult Treatment Panel III criteria; hypertension was classified by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure criteria. Enzymatic, colorimetric, and immunochemiluminometric techniques were used to measure plasma lipids, homocysteine, and high-sensitivity C-reactive protein, respectively.

RESULTS AND CONCLUSIONS

Dyslipidemia was identified in 74% of participants; 54% were overweight or obese (body mass index, >or=25 kg/m2); 61% were physically inactive (<1,000 kcal/wk); and 61% had some form of hypertension. In addition, 54% had increased homocysteine values; high-sensitivity C-reactive protein was elevated in 28%; and 22% of the participants met criteria for metabolic syndrome. In this study of the CVD risk profile among alcoholics, subjects were found to have an average of 3 CVD risk factors in addition to cigarette smoking. This prevalence and clustering of potentially modifiable risk factors in young, nicotine-dependent alcoholics indicate the need for aggressive risk reduction focused on prevention of CVD.