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. The National Health and Nutrition Examination Survey, among 10357 subjects,643 the prevalence of metabolic syndrome was higher in people with self-reported history of stroke (43.5%) than in those with no history of stroke or myocardial infarct (22.8%; P 0.001). The metabolic syndrome was independently associated with stroke history in all ethnic groups and in both sexes (OR, 2.16; 95% CI, 0.48 3.16). The association between metabolic syndrome and stroke has been confirmed in other populations, including those enriched with elderly subjects, and the frequency of the meta- bolic syndrome was notably higher in patients with a history of but also in Korean patients with The adjusted RRs for ischemic stroke asso- ciated with the metabolic syndrome in prospective studies has ranged between 2.10 and 2.47, and an HR as high as 5.15 has This predictive capacity does not appear to be influenced by the definition used for the metabolic syndrome and showed no significant variation across sex, age, or ethnic groups. 