['Metabolic syndrome is a characterized by a cluster of cardiovascular risk factors, including visceral obesity, insulin resistance, dyslipidemia, and hypertension. The criteria for diagnosing metabolic syndrome differ among ethnic groups, due in part to differences in eating habits and body build. Little is known about the relationship between metabolic syndrome and ischemic stroke in Asian countries. The aim of this study was to investigate the relationship between metabolic syndrome and first-time ischemic strokes.', 'Study subjects were 1,493 Japanese adults aged 55 years-old or older with no diabetes mellitus, no history of stroke and no neurological abnormalities, who participated in a voluntary neurological health screening at the Institute of Shimane Health Science, Japan (767 men, 62.0 +/- 5.9 years old at entry and 726 women, 61.8 +/- 5.1 years old at entry). All subjects were given an annual clinical stroke questionnaire. Clinical details of patients who reported strokes were confirmed with the attending physicians. Each subject was evaluated for an average of 6.4 +/- 3.8 years. Metabolic syndrome was defined using the modified criteria for Japanese population published in April 2005.', 'Metabolic syndrome was diagnosed in 11.0% of men and 1.1% of women. Adjusting for age and smoking, female subjects with metabolic syndrome had a 23.1-fold increased risk of suffering ischemic strokes [95% confidence interval (CI), 2.7-196], whereas metabolic syndrome did not increase the risk of ischemic stroke in men.'] Does metabolic syndrome increase the risk of ischemic stroke in women?