From Bottom Line's Daily Health News: (June 7, 2004)

METABOLIC SYNDROME

Doctors have discovered a whole new way to identify risk for heart disease and stroke. Rather than looking at individual risk factors, they have identified five core measures that, when viewed as a group, act as a significant indicator of future risk. If you have at least three of the five problems, you have "metabolic syndrome."

Components of the syndrome are elevated blood pressure, large waist circumference, elevated triglycerides, low HDL (the "good" cholesterol) count and elevated blood sugar level.

In a sense, metabolic syndrome is having a little bit wrong with a number of things. The bar for diagnosis of a syndrome risk factor is set lower than it is for a diagnosis of the actual disease.

For example, a fasting blood sugar level greater than 110 mg/dl is a syndrome risk factor, but a diabetes diagnosis requires a level of 126 mg/dl or higher. To be a syndrome risk factor, high blood pressure is 130 over 85 or higher... for a diagnosis of high blood pressure, the reading must be 140 over 90 or higher.

New research has shown that metabolic syndrome -- once called "syndrome X" -- is a significant risk for heart disease and stroke. Research on the Framingham Heart Study at Boston University School of Medicine showed that women who have the syndrome more than double their risk for stroke and men with it have a 78% greater risk for stroke compared with those who do not have the syndrome. The researchers presented their findings at the American Stroke Association's International Conference earlier this year.

I asked Ralph L. Sacco, MD, MS, professor of neurology and public health at Columbia University and a spokesperson for the American Stroke Association, about the implications of this study. He explained that no one is yet exactly sure why having the syndrome increases heart disease and stroke risk.

Dr. Sacco feels, however, that this research may hold the key to future treatment. Although a person with the syndrome has lower individual measures for disease, having them clustered in a group like this might warrant more aggressive treatment, starting earlier.

For the moment, Dr. Sacco points out that it is never too late for people to focus on prevention by eating a healthy diet, exercising and keeping their weight in the correct range. If that doesn't prevent metabolic syndrome, he says, talk to your doctor about possible medications that will help keep the measures down.