Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.
The term "metabolic" refers to the biochemical processes involved in the body's normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease.
In this article, "heart disease" refers to ischemic heart disease, a condition in which a waxy substance called plaque builds up inside the arteries that supply blood to the heart.
Plaque hardens and narrows the arteries, reducing blood flow to your heart muscle. This can lead to chest pain, a heart attack, heart damage, or even death.
Causes and Risk Factors of Metabolic Syndrome
Metabolic syndrome has several causes that act together, including:
- Abdominal obesity (large waistline)
- Inactive lifestyle
- Insulin resistance.
Some racial and ethnic groups in the United States are at higher risk for metabolic syndrome than others. Mexican Americans have the highest rate of metabolic syndrome, followed by whites and blacks.
Other groups at increased risk for metabolic syndrome include:
- People who have a personal history of diabetes
- People who have a sibling or parent who has diabetes
- Women when compared with men
- Women who have a personal history of polycystic ovarian syndrome (a tendency to develop cysts on the ovaries)
Preventing Metabolic Syndrome
The best way to prevent metabolic syndrome is to adopt heart-healthy lifestyle changes. Make sure to schedule routine doctor visits to keep track of your cholesterol, blood pressure, and blood sugar levels. Speak with your doctor about a blood test called a lipoprotein panel, which shows your levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.
Diagnosing Metabolic Syndrome
Your doctor will diagnose metabolic syndrome based on the results of a physical exam and blood tests. You must have at least three of the five metabolic risk factors to be diagnosed with metabolic syndrome.
A Large Waistline
Having a large waistline means that you carry excess weight around your waist (abdominal obesity). This is also called having an "apple-shaped" figure. Your doctor will measure your waist to find out whether you have a large waistline.
A waist measurement of 35 inches or more for women or 40 inches or more for men is a metabolic risk factor. A large waistline means you're at increased risk for heart disease and other health problems.
A High Triglyceride Level
Triglycerides are a type of fat found in the blood. A triglyceride level of 150 mg/dL or higher (or being on medicine to treat high triglycerides) is a metabolic risk factor. (The mg/dL is milligrams per deciliter—the units used to measure triglycerides, cholesterol, and blood sugar.)
A Low HDL Cholesterol Level
HDL cholesterol sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries.
An HDL cholesterol level of less than 50 mg/dL for women and less than 40 mg/dL for men (or being on medicine to treat low HDL cholesterol) is a metabolic risk factor.
High Blood Pressure
A blood pressure of 130/85 mmHg or higher (or being on medicine to treat high blood pressure) is a metabolic risk factor. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)
If only one of your two blood pressure numbers is high, you're still at risk for metabolic syndrome.
High Fasting Blood Sugar
A normal fasting blood sugar level is less than 100 mg/dL. A fasting blood sugar level between 100–125 mg/dL is considered prediabetes. A fasting blood sugar level of 126 mg/dL or higher is considered diabetes.
A fasting blood sugar level of 100 mg/dL or higher (or being on medicine to treat high blood sugar) is a metabolic risk factor.
About 85 percent of people who have type 2 diabetes—the most common type of diabetes—also have metabolic syndrome. These people have a much higher risk for heart disease than the 15 percent of people who have type 2 diabetes without metabolic syndrome.
Treatment for Metabolic Syndrome
Heart-healthy lifestyle changes are the first line of treatment for metabolic syndrome. If heart-healthy lifestyle changes aren’t enough, your doctor may prescribe medicines. Medicines are used to treat and control risk factors, such as high blood pressure, high triglycerides, low HDL (“good”) cholesterol, and high blood sugar.
The major goal of treating metabolic syndrome is to reduce the risk of ischemic heart disease. Treatment is directed first at lowering LDL cholesterol and high blood pressure and managing diabetes (if these conditions are present).
The second goal of treatment is to prevent the onset of type 2 diabetes, if it hasn’t already developed. Long-term complications of diabetes often include heart and kidney disease, vision loss, and foot or leg amputation. If diabetes is present, the goal of treatment is to reduce your risk for heart disease by controlling all of your risk factors.
Heart-healthy lifestyle changes include heart-healthy eating, aiming for a healthy weight, managing stress, physical activity, and quitting smoking.
Medicines such as statin medications can control or lower your cholesterol and decrease your chance of having a heart attack or stroke. Your doctor also may prescribe other medications to:
- Decrease your chance of having a heart attack or dying suddenly.
- Lower your blood pressure.
- Prevent blood clots, which can lead to heart attack or stroke.
- Reduce your heart’s workload and relieve symptoms of coronary heart disease.
Bariatric Surgery is often considered curative for metabolic syndrome, as it mitigates or eliminates a number of risk factors. If living a heart-healthy lifestyle and medications are not enough to reduce weight and control risk factors, discuss with your doctor if bariatric surgery may be an option for you.