Objectives: To explore 1. the presence of arterial stiffness, as measured with pulse wave velocity (PWV) in subjects with the Metabolic Syndrome (MetS) and 2. the contribution of PWV and the MetS in the prediction of prevalent CVD in a 50–70-year-old Dutch population-based cohort.

Background: Inconsistent results have been published about 1. the relations between arterial stiffness and the MetS and 2. the role of both in the prediction of CVD. Most studies have been performed in selected high-risk populations.

Method: We measured arterial stiffness by PWV using tonometry in 1510 participants of the Nijmegen Biomedical Study and determined its associations with different definitions of the MetS (according to the NCEP, IDF and WHO). Multiple regression analysis was performed tot determine the role of PWV and MetS in CVD risk prediction.

Results: Both men and women with the MetS had a significantly higher PWV than those without the MetS, independent of the definition used (for IDF: men:+MetS:9.5(2.3) vs −MetS11.1(3.1) m/s, women:+MetS:9.1(2) vs −MetS10.9(3) m/s). Age and gender were the main contributors to PWV, explaining 18.7% of the variance in PWV. Adding any definition of the MetS to the model increased the percentage explained variance of PWV to only 24% whereas adding all traditional CV risk factors predicted 43.1%. In regression analysis of prevalent CVD, the CV risk factors predicted 26.3% and adding PWV or the MetS did not improve the prediction of prevalent CVD.

Conclusion: Our results question the additive value of 1. using the definition of the MetS in the prediction of arterial stiffness and 2. measuring PWV and using the MetS in the prediction of prevalent CVD. Prospective studies have to determine the additive contribution of PWV and the MetS in CVD risk-prediction in general population.