After reviewing many studies and thousands of patients, researchers have found that certain variables, or risk factors, play an important role in the probability that a patient will develop heart disease. Researchers found that several heart disease risk factors cluster together in certain people. This clustering of risk factors is called metabolic syndrome. Metabolic syndrome is also called Reaven syndrome, insulin resistance syndrome, or metabolic syndrome X (not to be confused with cardiac syndrome X). Patients with metabolic syndrome have the following risk factors:
• An abdominal (waist) circumference greater than 40 inches for men or 35 inches for women
• An elevated fasting blood sugar measurement (or diabetes or glucose intolerance)
• High levels of triglycerides
• Low levels of HDL (good) cholesterol
• High blood pressure (hypertension)
Developing three or more of the above measurements constitutes metabolic syndrome, putting an individual at risk for developing type 2 diabetes, coronary artery disease, heart attack, or stroke.
What Causes Metabolic Syndrome?
Metabolic syndrome is most likely a genetic condition. Patients with insulin-resistant conditions (diabetes, glucose intolerance) are more likely to have metabolic syndrome, and as many as 10% to 30% of Americans have some form of insulin resistance. Too much insulin in the bloodstream increases the risk of heart attack because it:
• Raises triglyceride levels.
• Lowers the levels of HDL (good) cholesterol.
• Raises the levels of LDL (bad) cholesterol.
• Makes it more difficult for the body to clear fats from the blood after eating.
• Raises blood pressure.
• Increases the blood's clotting ability.
A diagnosis can be made when a patient develops three or more of the risk factors. Blood tests confirm glucose intolerance, insulin resistance, diabetes, cholesterol levels, and triglyceride levels. Physical examination confirms hypertension and obesity.
Metabolic syndrome is treated by treating the risk factors or underlying conditions. Patients with diabetes, glucose intolerance, high cholesterol, and hypertension should be under the care of a physician to receive proper medication and treatment. Lifestyle changes, including eating a proper diet, avoiding sugar and fat, stopping smoking, and drinking less alcohol are essential to restoring good health.
Because these problems are often linked, treating one aspect of the metabolic syndrome may help the other issues. For example, regular exercise can help to lose weight, reduce blood pressure, and manage hyperglycemia and insulin resistance. Combining healthful eating with a regular exercise program is the cornerstone of treating the metabolic syndrome and reducing the risk for heart disease, stroke, diabetes, and other medical problems.
Texas Heart Institute www.texasheartinstitute.com/HIC/Topics/Cond/metabolic.cfm
American Heart Association www.americanheart.org/presenter.jhtml?identifier=3044766
Medline Plus www.nlm.nih.gov/medlineplus/metabolicsyndrome.html
American Medical Association http://jama.ama-assn.org/cgi/reprint/295/7/850.pdf
Updated December 2009