Background: Metabolic syndrome (MetS) is a pathological condition varying according to the guidelines used, leading to ongoing debate on whether all these forms of defining MetS offer the same level of risk for developing cardiovascular diseases (CVDs). The aim of the study was: 1) to determine the prevalence of each type of MetS; 2) to assess the association of each type with CVDs over a 5-year follow-up period; and 3) to analyze whether each possible combination of MetS carries the same level of risk for developing CVD in the time above frame. Methods: This study is a secondary analysis of a Peruvian cohort database. The dependent variable was the development of CVD. In contrast, the independent variable was MetS, defined based on nine diagnostic methods: Adult Treatment Panel III (ATPIII), International Diabetes Federation (IDF), World Health Organization (WHO), Joint Interim Statemen...