OBJECTIVES: Patients presenting a cluster of cardiometabolic risk factors (CMRF) are at increased risk of developing cardiovascular disease (CVD). One possible clustering is the metabolic syndrome (MS). We investigated the long-term outcomes associated with MS in a Swiss population. METHODS: A computer simulation model was developed to project life expectancy (LE) and costs of treating CVD complications in Swiss patients with and without MS, using the National Cholesterol Education Program Adults Treatment panel III (NCEP/ATP III) definition. The 5-state Markov model utilized predictive regression equations and transition probabilities from the Framingham and PROCAM epidemiological studies. Patient characteristics were taken from the Lausanne Health Promotion Database which consisted of 9401 patients aged 18 to 79 years. Patients in the database were segmented according to their status of meeting the criteria of having MS, CMRF, and their age. Direct medical costs were accounted in 2005 Swiss Francs (CHF). Outcomes were projected over a lifetime horizon and discounted at 5% per annum. RESULTS: The presence of MS was projected to result in decreased LE by 2.29 years (16.27 vs 13.98 years) compared to individuals without the syndrome. The presence of MS was consistently associated with lower LE in all patient age groups. Direct medical costs of treating CVD complications in patients with MS were CHF 4413 higher than patients without the syndrome (CHF 8382 vs CHF 3969). The largest differences in cost were estimated for patients aged above 75 years (CHF 11,744 vs CHF 6707). CONCLUSION: On the basis of the NCEP/ATP III definition, our modeling analysis concludes that the presence of MS decreases LE (-2.29 years) and increases CVD costs (CHF 4413) per patient in the Swiss setting. These data suggest that the costs of future interventions targeted at the causes/management of MS could be offset by reduced CVD costs.