Syndrome Predicts Heart Disease in Healthy Adults

Middle-aged adults who do not yet have heart disease but have a spectrum of symptoms called metabolic syndrome are very likely to also have clogged arteries, researchers said on Monday.

The findings suggest primary care doctors should be screening patients for the signs of heart disease early and often, the researchers told a meeting of the American Heart Association. Then patients can begin to exercise and eat better to prevent heart disease, they said. The association defines metabolic syndrome as having three of five risk factors — a top blood pressure reading of more than 130, a blood glucose level of 120 or more, which can indicate risk for diabetes, high triglyceride levels, low levels of high density lipoprotein or “good” cholesterol, and a large waist. Association president-elect Dr. Robert Eckel says 27 percent of the U.S. population has metabolic syndrome — a relatively new term describing a condition that doctors agree shows a predisposition to heart disease. Dr. Kwame Akosah and colleagues at the Gundersen Lutheran Health System in La Crosse, Wisconsin, studied 246 adults with an average age of 53, looking for the signs of metabolic syndrome. None of the volunteers had any obvious symptoms of heart disease and they all qualified as having at low risk of heart disease using standard measures. Of the people they studied, 75 had metabolic syndrome, Akosah told a meeting of the Heart Association. The researchers also did an ultrasound scan of the carotid artery. These scans can find a thickening of this artery that shows whether the blood vessels are becoming clogged in a process called atherosclerosis. Of the 75 people with metabolic syndrome, 75 percent also had the beginnings of a clogged carotid artery, his team found. “If somebody had metabolic syndrome, in spite of a low (heart) risk category, that person had a greater than 2.5 times risk of having atherosclerosis present,” Akosah said. EARLIER CHECKS Many adults do not start getting standard physicals until the age of 40. The heart experts said the studies show Americans should see their doctors earlier and get blood glucose tests as well as blood pressure and cholesterol tests. While glucose is a test traditionally used to diagnose diabetes or pre-diabetes, it is clear that high glucose levels also point to a risk of heart disease, they said. In a second study, Dr. Donald Lloyd-Jones of Northwestern University in Chicago looked at statistics from a study of 2,400 adults that began nearly 20 years ago. He found that people whose weight stayed stable were much less likely to develop metabolic syndrome than people who gained 15 pounds (7 kg) or more over 15 years. “Only 18 percent of our volunteers were able to maintain a stable weight,” he said in an interview. They measured body mass index, a comparison of height to weight used globally to measure obesity. “Even if you started lean, if your BMI increased over the next 15 years, you had very steady changes in all the risk factors,” Lloyd-Jones told a news conference. For instance, in men whose BMI went up over the 15 years, triglycerides, an important component of cholesterol, went up an average of 3 points a year. Men whose weight stayed stable gained only 1 point a year. After 15 years, only 3.6 percent of the volunteers who had maintained their weight had developed metabolic syndrome, compared to 18 percent of those who gained weight. Lloyd-Jones said metabolic syndrome is something everyone can prevent. “It’s all about calories. It is definitely a lifestyle issue,” he said.(Source: American Heart Association: Reuters Health: Maggie Fox: November 2004.)