Guidelines for Metabolic Syndrome were last issued in 2005 by the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI). It was established by the panel that metabolic syndrome has no single cause. The most important risk factors, however, were abdominal obesity and insulin resistance (Medscape.org, 2005).

The scientific synopsis, which was published in a 2005 issue of Circulation, states that the syndrome is associated with increased long-term risks for atherosclerotic cardiovascular disease (ASCVD) and type-2 diabetes. Lifestyle changes “deserve prime consideration” for risk reduction. The interventions that the guidelines list are weight control, increased physical activity, and a diet designed to the reduce risk.

The lifestyle intervention goals in the guidelines for metabolic syndrome are as follows:

  • Abdominal obesity should reduce body weight by 7% – 10% during the first year and continued weight loss thereafter.
  • Waist circumference should be less than 40 in. for men and 35 in. for women.
  • Physical activity is to be of moderate intensity for 30 to 60 minutes, 5 to 7 days a week.
  • Diet should include a reduction of saturated fat, trans-fat, and cholesterol. The diet should consist of mostly unsaturated fat and a limited amount of simple sugars.

 

Clinical Guidelines for Metabolic Syndrome

 

Overall the previous criteria that were created by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) were found clinically useful. So the criteria were kept, with some minor modifications. The panel adjusted the waist circumferences to lower thresholds in cases where the patients were more prone to insulin resistance. Physicians are to consider triglyceride levels, HDL-C levels, and BP levels when prescribing drugs.

A patient may be diagnosed with metabolic syndrome if three of five clinical measures are met:

  • Central obesity of above 102 cm or 40 in for males, and 88 cm or 36 in
  • Dyslipidemia with a TG above 150 mg/dl
  • Dyslipidemia with a HDL-C level less than 40mg/dl for males, and 50 mg/dl for females
  • Blood pressure above 130/85 mmHg
  • Fasting plasma glucose level above 110 mg/dl

 

According to Medscape.org, the guidelines for metabolic syndrome state that patients who have had metabolic syndrome, and have had a relatively high 10 year risk for ASCVD, should have drug therapy for both major and metabolic risk factors to lower the risk. They suggest using pharmacotherapy according to present recommendation made by the AHA, NHLBI, and the America Diabetes Association (ADA) for individual risk factors.

 

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