Metabolic Syndrome
Metabolic syndrome is a group of risk factors for coronary artery disease (CAD). These include obesity, impaired fasting glucose (early diabetes), high blood pressure, and abnormal lipid levels.
Some studies report the prevalence of metabolic syndrome to be as high as 40% in the United States.
Metabolic syndrome arises in people who are genetically susceptible to the condition when they become sedentary and overweight. Obesity and a sedentary lifestyle cause the body to become insensitive to insulin, meaning it needs extra insulin to compensate and maintain normal blood sugar levels. This insensitivity, known as insulin resistance, leads to the afore mentioned abnormalities that define metabolic syndrome. In addition, obesity in and of itself also helps cause hypertension.Diagnosing Metabolic Syndrome
The American Heart Association identifies someone as having metabolic syndrome if they meet three or more of the following criteria:
- Abdominal obesity: waist circumference of >40 inches in men, >35 inches in women.
- Elevated triglycerides: 150 or greater mg/dl
- Decreased HDL cholesterol: <40 mg/dl in men, <50 mg/dl in women
- Elevated blood pressure: 130/85 mm Hg or greater
- Elevated fasting glucose: 100 mg/dl or greater
Treatment of Metabolic Syndrome
Treatment of metabolic syndrome involves treating the individual risk factors. Cholesterol and blood pressure medications are commonly used. Specifically, a class of blood pressure medication known as rennin-angiotensin blockers is known to prevent heart disease. This category of medications is broken down into two groups, the ACE inhibitors and the angiotensin receptor blockers.
However, making lifestyle changes are of most importance in treating metabolic syndrome. Increasing weight loss and physical activity get at the actual underlying cause(s) of the condition, while medications manage the consequences of it.
Before changing or starting any medication or exercise routine, discuss your plans with your physician. You will need regular follow-up and possible blood tests to make sure you’re on the right path toward preventing heart attacks.
Sources:
Cooper-DeHoff RM, Pepine CJ. Metabolic syndrome and cardiovascular disease: Challenges and Opportunities. Clin Cardiol 2007; 30: 593-7.
Cheung BM, Ong KL, Man YB, et al. Prevalence of the metabolic syndrome in the United States national health and nutrition examination survey 1999-2002 according to different defining criteria. J Clin Hypertens 2006;8:562-70.
Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393-403.