Abstract 19742: Effects of a "Health Partner" Intervention on the Metabolic Syndrome

Introduction: The Metabolic Syndrome (MetS) is highly prevalent, afflicting a third of U.S. adults, and confers higher cardiovascular morbidity and mortality. Features of MetS include abdominal obesity, elevated blood pressure, dysglycemia and atherogenic dyslipidemia. While lifestyle modifications are the first-line of MetS treatment, sustained adherence is achieved by a minority of patients. We investigated the effects of a Health Partner (HP) intervention on MetS. Methods and Results: A total of 119 university employees with MetS (51±9 years, 59% women, 26% African Americans) were enrolled in an academic program that promotes clinical self-knowledge and healthier lifestyles at the Center for Health Discovery and Well Being at Emory University in Atlanta, GA. Baseline anthropometric, laboratory and vascular function measurements were used by the HP to generate an action plan with detailed strategies to improve dietary and exercise habits, and subjects returned for follow up at 6 months and annually thereafter for 2 years. Repeated measures ANOVA showed statistically significant changes in waist circumference (p=0.007; baseline vs. 2 years: 103.1 vs. 98.2 cm), weight (p=0.004; 216.1±35 vs. 204.9±37 lbs), body fat percent (p=0.042; 39.6±7.4 vs. 38.1±7.9), fasting insulin levels (p=0.034; 11.4±8.3 vs. 7.9±9.9 μIU/ml), low density lipoprotein (p=0.005; 114.7±31.2 vs. 104.9±28.9 mg/dl), as well as a reduction in carotid-femoral pulse wave velocity (p=0.016; 7.4±2.2 vs. 6.7±1.1 m/s), systolic (p=0.001; 131.6±17.5 vs. 125.7±14.2 mmHg) and diastolic blood pressure (p=006; 84.7±11.1 vs. 80.1±10). There were no significant changes in glucose, triglyceride levels or brachial-artery flow mediated dilation. Conclusion: A personalized, goal directed HP intervention improves abnormalities associated with MetS, including body habitus, lipid and insulin secretion abnormalities, and resulted in significant blood pressure improvements that accompanied decreased central arterial stiffness. These improvements were sustained after two years of follow-up. Whether HP intervention improves long-term outcomes and whether it is cost-effective needs further investigation.

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HYPERTENSION MANAGEMENT IN METABOLIC SYNDROME

The Russian Archives of Internal Medicine ◽

10.20514/2226-6704-2019-9-5-327-347 ◽

2019 ◽

Vol 9 (5) ◽

pp. 327-347

Author(s):

E. V. Reznik ◽

I. G. Nikitin

Keyword(s):

Insulin Resistance ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Insulin Resistance Syndrome ◽

Effective Control ◽

Peripheral Tissues ◽

The Metabolic Syndrome ◽

Cardiovascular Morbidity And Mortality ◽

Therapy Target ◽

Based Medicine

Hypertension is one of the key risk factors for cardiovascular morbidity and mortality. Metabolic syndrome (synonyms: syndrome X, insulin resistance syndrome) is characterized by increased visceral fat mass, decreased sensitivity of peripheral tissues to insulin (insulin resistance) and hyperinsulinemia, which cause disorders of carbohydrate, lipid, and purine metabolism. Hypertension is an integral component of the metabolic syndrome. The severity of hypertension in patients with metabolic syndrome is higher in comparison with patients without metabolic disorders. In patients with metabolic syndrome, the probability of cardiac and brain damage increases fivefold, kidney damage threefold, and the vessels twofold. The presence of diabetes reduces the likelihood of achieving effective control of blood pressure by 1.4 times, hypercholesterolemia — by 1.5 times, obesity — by 1.7 times. In the presence of any three factors, the effectiveness of treatment is reduced twofold. In this article, approaches to the management of patients with hypertension and metabolic syndrome, aspects of non-drug therapy, target blood pressure levels, and the choice of drugs are presented in accordance with evidence-based medicine and current recommendations.

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Abstract 3488: Hyperuricemia and the Risk of Isolated Hypertension among Young People without Cardiovascular and Metabolic Risk Factors: The CARDIA Study

Circulation ◽

10.1161/circ.116.suppl_16.ii_790 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Eswar Krishnan ◽

Hyon K Choi ◽

Lewis H Kuller ◽

Kiang Liu

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Uric Acid ◽

Cardiovascular Risk ◽

Young People ◽

Cardiovascular Risk Factors ◽

Serum Uric Acid ◽

The Metabolic Syndrome

PURPOSE: The association between higher serum uric acid (SUA) levels and hypertension in the context of the metabolic syndrome is well known. If such an association was causal, one would expect to demonstrate a link between hyperuricemia and incidence of isolated hypertension - a hypothesis that has not been tested so far. METHODS: We used the 15-year limited-access data from the prospective cohort study of Coronary Artery Risk Development in young adults (CARDIA), sponsored by the National Institutes of Health, to identify a group of non-smoking young people with normal blood pressure and free of insulin resistance, hyperlipidemia, obesity, and a family history of cardiovascular diseases. These young people aged between 18 and 30 years at baseline were followed-up for a period of 15 years by 6 study visits where all cardiovascular risk factors were reassessed. Incidence of JNC-7 hypertension was the outcome of interest in Cox proportional hazards models where age, gender, race, lipid levels, blood pressure, alcohol, body mass index, smoking and serum insulin levels (time-varying where appropriate) were the covariates. Baseline serum uric acid (continuous) was the independent variable of interest. A second set of Cox regression analyses was performed among the subgroup of these individuals who remained free of all cardiovascular risk factors (except for hypertension) over the 15-year follow up. RESULTS: Out of the 5113 CARDIA participants at baseline, 2057 subjects were free of cardiovascular risk factors at baseline and were available for evaluation at year 15. Over the follow-up period, 828 subjects developed hypertension. In multivariate Cox models, each mg/dl increase in serum uric acid was associated with a hazard ratio of 1.45 (1.09–1.91). In the second set of analyses, 753 were free of all cardiovascular risk factors at baseline and remained free of any of the components of the metabolic syndrome except hypertension (n = 122 incident cases of hypertension) were studied. In these analyses each mg/dl increasse in SUA was associated with a risk adjusted hazard ratio of 1.60 (95% CI 1.02–2.49). CONCLUSIONS: Unrelated to the other features of the metabolic syndrome, higher levels of SUA among young people predicts isolated hypertension.

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Serum Phosphate, Blood Pressure, and the Metabolic Syndrome-20-Year Follow-Up of Middle-Aged Men

Journal of Clinical Hypertension ◽

10.1111/j.1751-7176.2008.00032.x ◽

2008 ◽

Vol 10 (11) ◽

pp. 814-821 ◽

Cited By ~ 5

Author(s):

Helga Gudmundsdottir ◽

Arne H. Strand ◽

Sverre E. Kjeldsen ◽

Aud Høieggen ◽

Ingrid Os

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Serum Phosphate ◽

Middle Aged ◽

The Metabolic Syndrome

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Metabolic Syndrome-Preventive Peptides Derived from Milk Proteins and Their Presence in Cheeses: A Review

Applied Sciences ◽

10.3390/app10082772 ◽

2020 ◽

Vol 10 (8) ◽

pp. 2772 ◽

Cited By ~ 1

Author(s):

Anna Iwaniak ◽

Damir Mogut

Keyword(s):

Insulin Resistance ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Blood Glucose ◽

Milk Proteins ◽

Atherogenic Dyslipidemia ◽

Converting Enzyme ◽

The Metabolic Syndrome ◽

Glucosidase Inhibitors ◽

Meta Analyses

The metabolic syndrome (MetS) is defined as the occurrence of diet-related diseases such as abdominal obesity, atherogenic dyslipidemia, hyperglycemia (insulin resistance) and hypertension. Milk-derived peptides are well-known agents acting against high blood pressure, blood glucose level, and lipoprotein disproportion. The aim of this review are metabolic syndrome-preventive peptides derived from milk proteins which were identified in cheeses. Special attention was paid to the sequences acting as angiotensin converting enzyme (ACE), dipeptidyl peptidase IV (DDP4), and α-glucosidase inhibitors, as well as antioxidative, hypocholesterolemic, antiobesity, and anti-inflammatory agents. Some results of meta-analyses concerning the consumption of cheese and the risk of MetS diseases were also presented.

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METABOLIC SYNDROME IN DIALYSIS PATIENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.5.1 ◽

2016 ◽

pp. 7-11

Author(s):

Vinh Phu Hoang ◽

Tam Vo ◽

Van Tien Le ◽

Thi Hoai Huong Vo

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Renal Failure ◽

Chronic Renal Failure ◽

Artificial Kidney ◽

Dialysis Patients ◽

Cross Sectional ◽

Average Value ◽

The Metabolic Syndrome ◽

End Stage

Objective: To review disorders elements of the metabolic syndrome in patients with end-stage chronic renal failure on dialysis cycle. Materials and methods: A cross sectional descriptive study of 85 patients including end-stage chronic renal failure in dialysis cycle from 5/2015 - 9/2016 at the Department of Artificial Kidney, Hue Central Hospital. Results: The prevalence of metabolic syndrome in dialysis patients was 37.65%. The prevalence of abdominal obesity was 30.6%; The prevalence of hypertension was 72.9%, the average value systolic blood pressure and diastolic blood pressure were 142.24 ± 27.53, 80.35 ± 12.48 mmHg; The prevalence of hyperglycemia was 28%, the average value blood glucose was 4.9 ± 1.19 mmol/l; The prevalence of triglyceride increase was 34.1%, the average value triglyceride was 1.59 ± 0.84 mmol/l. The prevalence of HDL-C increase was 47.1%, the average value HDL-C was 1.24 ± 0.33 mmol/l. Conclusion: The prevalence of metabolic syndrome in dialysis patients is very high, in which hypertension and HDL disturbances are the highest. Key words: chronic renal failure, dialysis, metabolic syndrome

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Small LDL, Atherogenic Dyslipidemia, and the Metabolic Syndrome

Circulation ◽

10.1161/01.cir.95.1.1 ◽

1997 ◽

Vol 95 (1) ◽

pp. 1-4 ◽

Cited By ~ 201

Author(s):

Scott M. Grundy

Keyword(s):

Metabolic Syndrome ◽

Atherogenic Dyslipidemia ◽

The Metabolic Syndrome

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Metabolic Syndrome Features and Excess Weight Were Inversely Associated with Nut Consumption after 1-Year Follow-Up in the PREDIMED-Plus Study

Journal of Nutrition ◽

10.1093/jn/nxaa289 ◽

2020 ◽

Vol 150 (12) ◽

pp. 3161-3170

Author(s):

Alicia Julibert ◽

Maria del Mar Bibiloni ◽

Laura Gallardo-Alfaro ◽

Manuela Abbate ◽

Miguel Á Martínez-González ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Energy Intake ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Virgin Olive Oil ◽

Hdl Cholesterol ◽

Excess Weight ◽

Study Cohort

ABSTRACT Background High nut consumption has been previously associated with decreased prevalence of metabolic syndrome (MetS) regardless of race and dietary patterns. Objectives The aim of this study was to assess whether changes in nut consumption over a 1-y follow-up are associated with changes in features of MetS in a middle-aged and older Spanish population at high cardiovascular disease risk. Methods This prospective 1-y follow-up cohort study, conducted in the framework of the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial, included 5800 men and women (55–75 y old) with overweight/obesity [BMI (in kg/m2) ≥27 and <40] and MetS. Nut consumption (almonds, pistachios, walnuts, and other nuts) was assessed using data from a validated FFQ. The primary outcome was the change from baseline to 1 y in features of MetS [waist circumference (WC), glycemia, HDL cholesterol, triglyceride (TG), and systolic and diastolic blood pressure] and excess weight (body weight and BMI) according to tertiles of change in nut consumption. Secondary outcomes included changes in dietary and lifestyle characteristics. A generalized linear model was used to compare 1-y changes in features of MetS, weight, dietary intakes, and lifestyle characteristics across tertiles of change in nut consumption. Results As nut consumption increased, between each tertile there was a significant decrease in WC, TG, systolic blood pressure, weight, and BMI (P < 0.05), and a significant increase in HDL cholesterol (only in women, P = 0.044). The interaction effect between time and group was significant for total energy intake (P < 0.001), adherence to the Mediterranean diet (MedDiet) (P < 0.001), and nut consumption (P < 0.001). Across tertiles of increasing nut consumption there was a significant increase in extra virgin olive oil intake and adherence to the MedDiet; change in energy intake, on the other hand, was inversely related to consumption of nuts. Conclusions Features of MetS and excess weight were inversely associated with nut consumption after a 1-y follow-up in the PREDIMED-Plus study cohort. This trial was registered at isrctn.com as ISRCTN89898870.

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A longitudinal study over 40 years to study the metabolic syndrome as a risk factor for cardiovascular diseases

Scientific Reports ◽

10.1038/s41598-021-82398-8 ◽

2021 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Lars Lind ◽

Johan Sundström ◽

Johan Ärnlöv ◽

Ulf Risérus ◽

Erik Lampa

Keyword(s):

Metabolic Syndrome ◽

Risk Factor ◽

Longitudinal Study ◽

Clinical Intervention ◽

The Elderly ◽

Adult Men ◽

The Metabolic Syndrome ◽

The Impact ◽

Over 40 Years

AbstractThe impact of most, but not all, cardiovascular risk factors decline by age. We investigated how the metabolic syndrome (MetS) was related to cardiovascular disease (CVD) during 40 years follow-up in the Uppsala Longitudinal Study of Adult Men (ULSAM, 2,123 men all aged 50 at baseline with reinvestigations at age 60, 70, 77 and 82). The strength of MetS as a risk factor of incident combined end-point of three outcomes (CVD) declined with ageing, as well as for myocardial infarction, ischemic stroke and heart failure when analysed separately. For CVD, the risk ratio declined from 2.77 (95% CI 1.90–4.05) at age 50 to 1.30 (95% CI 1.05–1.60) at age 82. In conclusion, the strength of MetS as a risk factor of incident CVD declined with age. Since MetS was significantly related to incident CVD also at old age, our findings suggest that the occurrence of MetS in the elderly should not be regarded as innocent. However, since our data were derived in an observational study, any impact of MetS in the elderly needs to be verified in a randomized clinical intervention trial.

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Components Analysis of Metabolic Syndrome in Acute Myocardial Infarction Patients

TAJ Journal of Teachers Association ◽

10.3329/taj.v29i2.39100 ◽

2018 ◽

Vol 29 (2) ◽

pp. 6-10

Author(s):

Khan MMR ◽

Sana NK ◽

PM Basak ◽

BC Sarker ◽

M Akhtarul Islam ◽

...

Keyword(s):

Myocardial Infarction ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Acute Myocardial Infarction ◽

High Blood Pressure ◽

Abdominal Obesity ◽

Premature Death ◽

Medical College ◽

The Metabolic Syndrome ◽

Low Hdl

Background: Metabolic syndrome confers the risk of developing acute myocardial infarction which is the most common form of coronary heart disease and the single most important cause of premature death worldwide. The frequency and association of different components of metabolic syndrome on AMI are not well understood and has not been well evaluated.Objective: The aim of this study was to assess the components of the metabolic syndrome and its association with AMI patients. This study will help in awareness building in reducing AMI by early detection of components of metabolic syndrome.Patients and methods: This was a prospective observational study consisted of 325 AMI patients who were aged >20 years. Patients with first time AMI arriving in CCU of Rajshahi medical college during the period of 2012-2014, were included. Data were collected through interview, clinical examination, and laboratory tests within 24 hrs of AMI. Five components of metabolic syndrome were defined according to criteria set by modified NCEP ATP III (according to ethnic variation).Results: In AMI patients (n=325), no metabolic components were in 24 (7.4%) patients, one in 53 (16.3%), 2 components in 91(28.0%), 3 components were in 61(18.8%), 4 in 67(20.6%) and all 5 components were in 29 (8.9%) patients. In this study, there was no component in 7.4% of AMI patients, at least 1 component was 92.6%, at least 2 components were 76.3%, at least 3 components were 48.3%, at least 4 components were 29.5% and at least 5 components were 8.9%. The Metabolic syndrome was 48.3% (n=157). Among metabolic syndrome (≥3 components) in AMI (n=157, 48.3%) 4 components (20.6%) were more, next was 3 components (18.8%) and than 5 components (8.9%). Overall frequencies of components in acute myocardial infarction (n=325) were in order of abdominal obesity (54.8%) > high blood pressure (54.5%) > high FPG (54.2%) > Triglyceride (46.2%) and low HDL-C (46.2%) in acute myocardial infarction. Highest percentage was observed in abdominal obesity (54.8%) followed by high blood pressure (54.5%) and FPG (54.2%).TAJ 2016; 29(2): 6-10

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