Baton Rouge Clinic Health Library

Cardiovascular Health > Heart disease risk increased with common condition

     Published: 02, 2004

We all know of the classic heart disease risk factors: obesity, physical inactivity, smoking, high cholesterol, hypertension, and diabetes. These factors are all too prevalent in Louisiana and the major reason cardiovascular disease is the number one killer in the state and in the nation. However, an increasingly recognized condition, metabolic syndrome, is alarmingly present in our society. It is estimated that one-fourth of all adult Americans have this condition!

Dr. David G. Carmouche, an Internist at The Baton Rouge Clinic, AMC, explains that metabolic syndrome is a clustering of risk factors in an individual. The syndrome is defined as: 1) waist circumference greater than 40 inches in a man or 35 inches in a woman (measured just below the ribs, not the beltline); 2) blood pressure over 130/ 85 or on high blood pressure medication; 3) fasting blood sugar over 110; 4) fasting triglyceride level over 150; 5) Low HDL cholesterol – less than 40 in men, less than 50 in women. “The presence of any three of these factors defines the presence of the syndrome,” said Dr. Carmouche. “Patients with 4 or 5 factors are at even higher risk.”

Metabolic syndrome has both genetic and environmental causes. Patients inherit a set of genes causing an underlying defect termed insulin resistance. In this condition, the pancreas is forced to produce higher levels of insulin for the body to effectively utilize sugar. When patients are then sedentary and overeat high calorie foods, the full syndrome develops. Common Condition Markedly Increases Risk of Heart Disease.

Why all the fuss? “Patients with metabolic syndrome have a two to three times the risk of coronary artery disease and a very high risk of developing diabetes,” said Dr. Carmouche. “In fact, metabolic syndrome is particularly dangerous in that it tends to be associated with accelerated development of heart disease, frequently presenting between the age of 40-50 in men, and a decade or so later in women.”

Fortunately, this condition is controllable. The hallmark of treatment is diet and exercise. While this seems to be the case for most cardiovascular disease risk factors, it is particularly so in metabolic syndrome. Several large clinical trials have shown that regular exercise and appropriate diet decrease the progression to diabetes in patients with metabolic syndrome. In fact, diet and exercise performed better as an intervention than did certain medications.

In general, patients with metabolic syndrome require daily exercise for approximately 30 minutes. Sedentary individuals should consult their physicians prior to embarking on a new exercise regimen. “The form of exercise seems less important than the consistency of exercise,” according to Dr. Carmouche. He continued, “Do something you enjoy, and incorporate it into your daily schedule. Finding a partner to exercise with is helpful in maintaining a regular routine.”

Dr. Carmouche said that clinical nutritionists and dieticians provide the best information on appropriate diets. “In general, metabolic syndrome patients need calorie restriction to reduce weight. Preliminary data suggests that lower carbohydrate diets may be particularly beneficial in these patients, though there are no long term studies.” Heart-healthy diet information can be found online at www.americanheart.org.

Despite dietary and exercise efforts, many metabolic syndrome patients will remain at risk. “Many different medications are available to control blood pressure, cholesterol, and blood sugar and frequently these drugs are prescribed in combination.” Dr. Carmouche continued, “Patients and physicians need to have a sense of urgency in treating metabolic syndrome, and if diet and exercise do not bring this condition under control within 3-6 months, medication should be used.”

Dr. Carmouche concluded, “Diagnosing metabolic syndrome is not difficult, but it does require measurement of blood pressure, blood glucose, and cholesterol. Patients who feel they may be at risk should seek this testing as soon as possible.” One opportunity for this testing is Saturday, February 14, 2004 at Pennington Biomedical Conference Center from 8: 00 a.m. – 12:00 noon at the “Heart of Baton Rouge”, a heart healthy family fair. The Baton Rouge Clinic is proud to be the major sponsor and invites all those interested in their health to attend!

David G. Carmouche, MD
Specializing in The Cardiovascular Center of Excellence

The Baton Rouge Clinic, AMC, offers this information as a courtesy service. Please remember that medical knowledge is always evolving and we cannot represent that any of our information is absolutely current. Please consult a physician before taking any medical action based on information gathered from this or any website.