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Cardiovascular disease is a major killer in the US and worldwide. Although many of the major factors contributing to atherosclerosis have been described over the past half-century, highly sophisticated investigations into its causes are ongoing. Family history is an important predictor of future heart disease, but the findings of recent genome-wide association studies have not demonstrated effect sizes that are large enough to explain the observed familial trends. We are left to suppose that the strong family-history effect in large part represents an effect of lifestyle. This hypothesis is strengthened by a recently published manuscript by Koskinen and coworkers regarding the effects of recovery from metabolic syndrome on arterial structure and function (1).The study of Koskinen et al. (1) was based on data from the Cardiovascular Risk in Young Finns Study, an ongoing epidemiologic survey of Finnish males and females first examined in childhood (age 3–18 years) in 1980. There have been 2 subsequent examinations in 2001 and 2007, both of which have included anthropometrics and lipid and vascular measures, including carotid intima–media thickness (IMT)1 and distensibility, as well as brachial flow-mediated dilation (FMD) in response to ischemia induced with a blood pressure cuff. This 2010 publication (1) reports on members of the original cohort who both participated in follow-up examinations and provided data for comparison. The follow-up examinations also included information on nutrition (food frequency questionnaires) and physical activity (“metabolic equivalent index”), as well as a panel of testing that allows a designation of metabolic syndrome at both time points. Thus, the authors were able to correlate changes in metabolic abnormalities over time, and the presence of metabolic syndrome, to several vascular findings. These changes are most likely attributable to alterations in lifestyle that occurred over the course of the 6-year follow-up period.Results of the …

Recovery from Metabolic Syndrome Is Both Possible and Beneficial