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. Yet, in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial, the 642 subjects with the metabolic syndrome and a previous stroke or TIA did not experience an increased risk of stroke.654 Although many stud- ies have used >1 definition of the metabolic syndrome to assess the risk for stroke, the harmonized definition may prove to be superior in establishing the relationship.655,656 There are essentially no trial data that have addressed the effects of treatment on cardiovascular morbidity and mortal- ity in patients with the metabolic syndrome. In the JUPITER Trial, 17802 healthy men and women with LDL cholesterol levels <130 mg/dL and hs-CRP levels 2.0 mg/L were ran- domized to receive rosuvastatin 20 mg daily or placebo and followed up for the occurrence of the combined primary end point of MI, stroke, arterial revascularization, hospitalization for unstable angina, or death resulting from cardiovascular The rates were reduced by a hazard ratio of 0.56 (95% CI, 0.46 0.69) for the primary end point, 0.46 (95% CI, 0.30 0.70) for MI, and 0.52 (95% CI, 0.34 0.79) for stroke. Patients with or without the metabolic syndrome had similar reductions in CVD events. 