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The metabolic syndrome - What is it and how should it be managed?

Nilsson, Peter M. LU ; Tuomilehto, Jaakko and Rydén, Lars (2019) In European Journal of Preventive Cardiology 26(2). p.33-46
Abstract

A cluster of metabolic factors have been merged into an entity named the metabolic syndrome. Although the characteristics of this syndrome have varied over time the presently used definition was established in 2009. The presence of three abnormal findings out of five components qualifies a person for the metabolic syndrome: elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting plasma glucose. Cut points have been defined for all components apart from waist circumference, for which national or regional values are used. The metabolic syndrome predicts cardiovascular disease and type 2 diabetes. This associated risk does not exceed its components... (More)

A cluster of metabolic factors have been merged into an entity named the metabolic syndrome. Although the characteristics of this syndrome have varied over time the presently used definition was established in 2009. The presence of three abnormal findings out of five components qualifies a person for the metabolic syndrome: elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting plasma glucose. Cut points have been defined for all components apart from waist circumference, for which national or regional values are used. The metabolic syndrome predicts cardiovascular disease and type 2 diabetes. This associated risk does not exceed its components whereof elevated blood pressure is the most frequent. A successful management should, however, address all factors involved. The management is always based on healthy lifestyle choices but has not infrequently to be supported by pharmacological treatment, especially blood pressure lowering drugs. The metabolic syndrome is a useful example of the importance of multiple targets for preventive interventions. To be successful management has to be individualized not the least when it comes to pharmacological therapy. Frail elderly people should not be over-treated. Knowledge transfer of how risk factors act should be accompanied by continuous trust building and motivation. In complex situations with a mix of biological risk factors, adverse social conditions and unhealthy lifestyle, everything cannot be changed at once. It is better to aim for small steps that are lasting than large, unsustainable steps with relapses to unhealthy behaviours. A person with the metabolic syndrome will always be afflicted by its components, which is the reason that management has to be sustained over a very long time. This review summarizes the knowledge on the metabolic syndrome and its management according to present state of the art.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
blood lipids, blood pressure, Cardiovascular risk, dietary habits, lifestyle, physical activity, plasma glucose, risk for type 2 diabetes, waist circumference
in
European Journal of Preventive Cardiology
volume
26
issue
2
pages
14 pages
publisher
Oxford University Press
external identifiers
  • scopus:85075581678
  • pmid:31766917
ISSN
2047-4881
DOI
10.1177/2047487319886404
language
English
LU publication?
yes
id
39f97e4e-9fdf-4ac6-b2eb-9722010d1f79
date added to LUP
2019-12-04 13:18:45
date last changed
2021-03-03 02:34:47
@article{39f97e4e-9fdf-4ac6-b2eb-9722010d1f79,
  abstract     = {<p>A cluster of metabolic factors have been merged into an entity named the metabolic syndrome. Although the characteristics of this syndrome have varied over time the presently used definition was established in 2009. The presence of three abnormal findings out of five components qualifies a person for the metabolic syndrome: elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting plasma glucose. Cut points have been defined for all components apart from waist circumference, for which national or regional values are used. The metabolic syndrome predicts cardiovascular disease and type 2 diabetes. This associated risk does not exceed its components whereof elevated blood pressure is the most frequent. A successful management should, however, address all factors involved. The management is always based on healthy lifestyle choices but has not infrequently to be supported by pharmacological treatment, especially blood pressure lowering drugs. The metabolic syndrome is a useful example of the importance of multiple targets for preventive interventions. To be successful management has to be individualized not the least when it comes to pharmacological therapy. Frail elderly people should not be over-treated. Knowledge transfer of how risk factors act should be accompanied by continuous trust building and motivation. In complex situations with a mix of biological risk factors, adverse social conditions and unhealthy lifestyle, everything cannot be changed at once. It is better to aim for small steps that are lasting than large, unsustainable steps with relapses to unhealthy behaviours. A person with the metabolic syndrome will always be afflicted by its components, which is the reason that management has to be sustained over a very long time. This review summarizes the knowledge on the metabolic syndrome and its management according to present state of the art.</p>},
  author       = {Nilsson, Peter M. and Tuomilehto, Jaakko and Rydén, Lars},
  issn         = {2047-4881},
  language     = {eng},
  number       = {2},
  pages        = {33--46},
  publisher    = {Oxford University Press},
  series       = {European Journal of Preventive Cardiology},
  title        = {The metabolic syndrome - What is it and how should it be managed?},
  url          = {http://dx.doi.org/10.1177/2047487319886404},
  doi          = {10.1177/2047487319886404},
  volume       = {26},
  year         = {2019},
}