Prevalence increased with age, with the highest prevalence in subjects between 60 to 69 years of age. Prevalence was lower among black men than white or Mexican American men and lower among white women than among black or Mexican American women. Mostly attributable to the obligatory use of a lower waist circumference for the IDF, the IDF definition led to higher estimates of prevalence in all demographic groups, especially among MexicanAmerican men. Hyperinsulinemia/insulin resistance is an important marker of the metabolic syndrome; however, results concerning a relationship between glucose intolerance and stroke risk In 18990 men and women who were screened for entry into the Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) trial from 21 different countries, 8000 subjects were normoglyce- mic, 8427 had impaired fasting glucose or impaired glucose tolerance, and 2563 had newly diagnosed type 2 diabetes mel- Among all subjects, an 18-mg/dL increase in fasting plasma glucose or a 45-mg/dL increase in the 2-hour glucose after an oral glucose tolerance test was associated with an increase in cardiovascular events, including stroke or death (HR, 1.17; 95% CI, 1.13 1.22). The relationships between other individual components of the metabolic syndrome and stroke risk, including elevated BP, are reviewed in other sec- tions of this guideline. The metabolic syndrome is a predictor of CVD and vascular death; however, this risk does not appear to be any larger than the sum of the components of the syndrome.626,641 A similar lack of greater predictability is true for the metabolic syndrome and This lack of relationship may be because of sample size or a small number of stroke events. 