Over the course of the last several years, a number of factors that increase the risk of heart and blood vessel disease have been identified. Many people understand the health implications of tobacco use and high blood pressure in this regard. A very important group of risk factors, known collectively as the metabolic syndrome, have now moved into the forefront in risk reduction efforts.
The National Cholesterol Education Program Adult Treatment Panel III has recently identified the metabolic syndrome as a very significant risk factor for the development of cardiovascular disease and diabetes. The American Medical Association and the National Heart, Lung and Blood Institute have also presented information regarding the need for the clinical management of the metabolic syndrome. The metabolic syndrome is present when any three of the following risk factors are present:
- Abdominal obesity (men with a waist circumference of greater than 40 inches or women with a waist circumference greater than 35 inches).
- An elevated triglyceride level of greater than 150 mg/dL.
- A low HDL cholesterol (less than 40 mg in men or less than 50 mg in women).
- A blood pressure greater than 130/85, or a fasting blood glucose measurement of greater than 110 mg/dL.
The metabolic syndrome seems to be more prevalent with age, although young people are susceptible as well. Currently, it is thought that as many as one third of overweight or obese people manifest the metabolic syndrome. The treatment of the metabolic syndrome is related to the management of the individual risk factors that may be present. Lifestyle modifications, such as weight loss and physical activity, are obviously first lines of therapy. In addition, the use of medication to control blood pressure and blood glucose may also be useful.