Metabolic Syndrome risk factors

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Patients with multiple risk factors, particularly those with diabetes, are at the greatest risk for IHD. Metabolic syndrome is a constellation of cardiovascular risk factors related to hypertension, abdominal obesity, dyslipidemia, and insulin... 

Control of existing risk factors and the presence of new risk factors for IHD should also be assessed regularly. Routine screening for the presence of metabolic syndrome will help in assessing the control of known major risk factors and identifying new risk factors. If new risk factors are identified and/or the presence of metabolic syndrome is detected, modify the pharmacotherapy regimen, as discussed previously, to control these risk factors and lower the risk of IHD and IHD-related adverse events. 

The diagnosis of metabolic syndrome is made when three or more of the following risk factors are present 3,10... 

Insulin resistance has been associated with a number of other cardiovascular risks, including abdominal obesity, hypertension, dyslipidemia, hypercoagulation, and hyperinsulinemia. The clustering of these risk factors has been termed metabolic syndrome. It is estimated that 50% of the United States population older than 60 years of age have metabolic syndrome. The most widely used criteria to define metabolic syndrome were established by the National Cholesterol Education Program Adult Treatment Panel III Guidelines (summarized in Table 40-2). 

Zarich SW. Cardiovascular risk factors in the metabolic syndrome impact of insulin resistance on lipids, hypertension, and the development of diabetes and cardiac events. Rev CardiovascMed. 2005 6 194-205. 

Lifestyle factors have been associated with ED in both cross-sectional and longitudinal studies. In particular, obesity and sedentary lifestyle are clear-cut risk factors for ED, both in men with comorbid illnesses such as hypertension and diabetes, and especially in men without overt cardiovascular disease (50). Other lifestyle factors, such as smoking and alcohol consumption, have been implicated in some, but not all, studies to date. Intervening on cardiovascular and lifestyle factors may have broader benefits beyond restoration of erectile function. This important concept needs careful consideration, as recent studies have implicated the role of the metabolic syndrome, obesity, insulin resistance, and lack of exercise as independent risk factors for both ED and cardiovascular disease (51,52). 

Straznicky NE, Lambert EA, Lambert GW, Masuo K, Esler MD, Nestle PJ. Effects of dietary weight loss on sympathetic activity and cardiac risk factors associated with the metabolic syndrome. J. Clin. Endocrinol. Metab. 2005 90 5998-6005. 

A metabolic syndrome is said to be present when at least three of the following five risk factors can be identified in a patient ... 

Overweight and resistance to insulin appear to play pivotal roles in the pathophysiological process. The resulting hyperinsulinemia induces a rise in systemic arterial blood pressure and probably also a hyperglyceridemia associated with an unfavorable LDL/HDL quotient. This combination of risk factors lowers life expectancy and calls for therapeutic intervention. The metabolic syndrome has a high prevalence in industrialized countries, up to 20% of adults are believed to suffer from it. 

Various anatomical, physiological and behavioural risk factors for atherosclerosis are known. Many of these are recognised within the metabolic syndrome , a combination of disorders that increases the risk of developing cardiovascular disease and diabetes. Prevalence increases with age, affecting up to 25% of the population in the USA. Risk factors include ... 

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Investigators at the University College London evaluated data from more than ten thousand civil service workers. Compared with subjects who didn t report job-related stress, people who told of work stress three or more times over the span of the fourteen-year study had double the risk of metabolic syndrome, which includes elevated blood pressure along with other heart-related risk factors. People complaining of work stress typically were in jobs with high demands and low levels of control. 

Metabolic syndrome versus additive cardiometabolic risk factors... 

Grundy SM. Metabolic syndrome a multiplex cardiovascular risk factor. Clin. Endocrinol. Metab. 2007 92 399-404. 

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