Metabolic Syndrome: Are You at Risk?

The meaning of “metabolic syndrome” is still a mystery to many Americans. However, the syndrome’s significance in diagnosing cardiovascular disease is quickly catching on with family practices and primary care physicians.

That’s because metabolic syndrome has become much more common in the United States, with up to 25 percent of adult Americans estimated to have it, according to the American Heart Association.

The AHA calls it the “tip of an iceberg,” signaling to physicians that treatment is needed to control more than one risk factor.

The key element of metabolic syndrome is insulin resistance, a condition that can be present before metabolic syndrome is diagnosed. Insulin resistance means that your body’s ability to effectively use insulin — a life-sustaining hormone — has been impaired.

“Without insulin, the body cannot convert sugar from food into nutrients for cells,” according to JDRF, a leading diabetes research organization. “Excess sugar builds up in the bloodstream and may eventually cause severe damage to organs and premature death.”

The biggest underlying causes of metabolic syndrome are obesity and physical inactivity.

“Patients need to know that metabolic syndrome is serious,” said Jonathan Fialkow, M.D., medical director of clinical cardiology at Baptist Cardiac & Vascular Institute and a certified lipidologist. “Metabolic  syndrome is directly linked to increased inflammatory state in our body and, specifically, our blood vessels. It is directly linked to carbohydrate intake.”

Metabolic syndrome actually does not refer to a single condition. It encompasses a group of risk factors — such as high blood pressure, high blood sugar, undesirable cholesterol levels, and a large waist size.

Individually, these risk factors post a risk to your health. But when they come together in a single patient, they can add up to much more serious problems.

The risk factors — in some combinations — can double your risk for cardiovascular disease, which can lead to heart attacks and strokes.

Some of the causes of metabolic syndrome are within the patient’s control, such as dietary intake or an inactive lifestyle. The others are not within the patient’s control, such as ethnicity and genetics.

“There is a need for more awareness among people who carry these risk factors, so that they can begin to make lifestyle changes, such as healthier eating and starting exercise programs,” said Khurram Nasir, M.D., M.P.H. research director of Baptist Health’s wellness and prevention program, as well as director of the High Risk Cardiovascular Clinic and senior research scholar for Baptist Cardiac & Vascular Institute.

According to the National Heart, Lung and Blood Institute, a person who has metabolic syndrome is not only twice as likely to develop heart disease, but also five times as likely to develop diabetes, compared to someone who doesn’t have metabolic syndrome.

Diagnosing Metabolic Syndrome

According to the American Heart Association, you have metabolic syndrome if you at least three of the following at the same time:

•  Waist circumference over 35 inches for women and 40 inches for men

•  Elevated level of triglycerides

•  Reduced HDL (the “good” cholesterol”); Men — Less than 40 mg/dL; Women — Less than 50 mg/dL

•  Elevated blood pressure of 130/85 mm Hg or higher

•  Elevated fasting blood sugar of 100 mg/dL or more.

Treating Metabolic Syndrome

You can reduce the risk for cardiovascular disease and Type 2 diabetes by controlling risk factors. The best way is by losing weight and increasing physical activity. Here are some tips for managing metabolic syndrome:

•  Routinely monitor body weight (especially central obesity, or fat concentrated in the abdomen). Also monitor blood glucose, lipoproteins and blood pressure.

•  Treat each risk factor, such as high blood pressure and high blood glucose, according to established guidelines and the advice of your physician.

•  Carefully choose high blood pressure drugs or other medications because different drugs have different effects on insulin sensitivity.