Under-recognition of metabolic syndrome in North West London (2000-2023): a 23-year retrospective analysis.
5 affiliations
- 1Institute of Global Health Innovation, Imperial College London, London, UK.
- 2Imperial College Healthcare NHS Trust, London, UK.
- 3Imperial College Healthcare Partners, London, England, UK.
- 4OptumLabs, Cambridge, Massachusetts, USA.
- 5Department of Immunology and Inflammation, Imperial College London, London, UK.
Abstract
Introduction
Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors associated with increased morbidity and mortality. Despite the rising prevalence of obesity, hypertension, dyslipidaemia and glucose dysregulation, MetS remains inconsistently recognised and coded within electronic health records (EHRs). We aimed to determine the extent of under-recognition of MetS within North West London (NWL) over a 23-year period.Methods
The Discover-NOW London Secure Data Environment dataset was retrospectively analysed between 1 January 2000 and 31 July 2023. Adults aged ≥18 years were identified as having MetS if coded within EHRs or if they met ≥3 of 5 American Heart Association (AHA) 2005 diagnostic criteria. An Extended AHA definition incorporating BMI and HbA1c was also applied to reflect routine clinical practice.Results
Among 2 096 480 adults registered in NWL during the study period, 975 individuals (0.04%) had a clinician-coded diagnosis of MetS. In contrast, 594 325 individuals (21.2%) met AHA-defined criteria and 875 993 (31.3%) met Extended AHA-defined criteria. Women, individuals of Black or Black British ethnicity, and those from more deprived areas were under-represented in the coded cohort relative to algorithm-defined cohorts.Conclusion
Metabolic syndrome is substantially under-recorded within routine clinical coding in NWL. Recognition of the true prevalence of MetS within healthcare datasets may support improved risk stratification, enable population-level surveillance, and facilitate evaluation of MetS-related morbidity and healthcare utilisation.
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BibTeX
@article{dattani2026underrecognition,
title = {{Under-recognition of metabolic syndrome in North West London (2000-2023): a 23-year retrospective analysis.}},
author = {Rakesh Dattani and Benjamin Pierce and Gulam Muktadir and Heather Fitzke and Evgeny Galimov and Mahed Abroshan and Zia Ul-Haq and Frederick Wai Keung Tam and Ara Darzi and Hutan Ashrafian},
journal = {BMJ public health},
year = {2026},
month = oct,
doi = {10.1136/bmjph-2025-003029},
url = {https://europepmc.org/article/MED/42948608},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Under-recognition of metabolic syndrome in North West London (2000-2023): a 23-year retrospective analysis.
AU - Rakesh Dattani
AU - Benjamin Pierce
AU - Gulam Muktadir
AU - Heather Fitzke
AU - Evgeny Galimov
AU - Mahed Abroshan
AU - Zia Ul-Haq
AU - Frederick Wai Keung Tam
AU - Ara Darzi
AU - Hutan Ashrafian
PY - 2026
DA - 2026/10/26
JO - BMJ public health
DO - 10.1136/bmjph-2025-003029
UR - https://europepmc.org/article/MED/42948608
AB - Introduction Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors associated with increased morbidity and mortality. Despite the rising prevalence of obesity, hypertension, dyslipidaemia and glucose dysregulation, MetS remains inconsistently recognised and coded within electronic health records (EHRs). We aimed to determine the extent of under-recognition of MetS within North West London (NWL) over a 23-year period.Methods The Discover-NOW London Secure Data Environment dataset was retrospectively analysed between 1 January 2000 and 31 July 2023. Adults aged ≥18 years were identified as having MetS if coded within EHRs or if they met ≥3 of 5 American Heart Association (AHA) 2005 diagnostic criteria. An Extended AHA definition incorporating BMI and HbA1c was also applied to reflect routine clinical practice.Results Among 2 096 480 adults registered in NWL during the study period, 975 individuals (0.04%) had a clinician-coded diagnosis of MetS. In contrast, 594 325 individuals (21.2%) met AHA-defined criteria and 875 993 (31.3%) met Extended AHA-defined criteria. Women, individuals of Black or Black British ethnicity, and those from more deprived areas were under-represented in the coded cohort relative to algorithm-defined cohorts.Conclusion Metabolic syndrome is substantially under-recorded within routine clinical coding in NWL. Recognition of the true prevalence of MetS within healthcare datasets may support improved risk stratification, enable population-level surveillance, and facilitate evaluation of MetS-related morbidity and healthcare utilisation.
SN - 2753-4294
ER -