Heart Health
Alert: This hidden condition increases heart attack and stroke risks
Find out if you have the components of metabolic syndrome.
- Reviewed by Anthony L. Komaroff, MD, Editor in Chief, Harvard Health Letter; Editorial Advisory Board Member, Harvard Health Publishing
It has an unfamiliar name, produces few symptoms, and involves a cluster of health problems. But metabolic syndrome is a common and dangerous condition that's steadily increasing in adults of all ages in the United States, largely a result of the obesity epidemic. The syndrome significantly increases the risks for heart attacks, strokes, diabetes, and more.
What is it?
Metabolic syndrome is a constellation of interrelated conditions. A diagnosis requires at least three of the following cardiovascular risk factors.
Obesity. You have this risk factor if your waistline is greater than 40 inches for men or 35 inches for women, no matter your height, or if your body mass index is 30 or more.
High blood sugar. After you eat, your body converts carbohydrates into blood glucose, a type of sugar that the body uses for energy. Sugar in the blood then enters your cells, where it's needed to produce energy. In people with diabetes or prone to it, this process is impaired, raising sugar levels in the blood and damaging the cells and blood vessels. A fasting blood sugar level of 100 milligrams per deciliter of blood (mg/dL) or more is considered high. Having diabetes (a fasting blood sugar of 126 mg/dL or higher) also counts as a metabolic syndrome risk factor.
High triglycerides. Triglycerides are a type of fat in the blood. Having a high level — 150 mg/dL or higher — increases your risk for heart disease and stroke. You can find your triglyceride levels in your cholesterol test results.
Low HDL (good) cholesterol. HDL is another type of fat in the blood. It helps remove LDL (bad) cholesterol. If your HDL is below 40 mg/dL in men or 50 mg/dL in women, it's considered low.
High blood pressure. Blood pressure is considered high if your systolic pressure (the top number in a measurement) is 130 millimeters of mercury (mm Hg) or higher, or your diastolic pressure (the bottom number) is 80 mm Hg or higher. If you're already taking medication for high blood pressure, you should still count this condition as a metabolic risk factor.
What does it mean?
When three or more of these risk factors occur together, metabolic syndrome is present, and numerous studies have shown that means you have higher risks for heart disease and stroke.
"Having just one of the risk factors is bad enough. But having more makes the likelihood of bad health outcomes greater. That's why clinicians developed the term metabolic syndrome many years ago: it helped identify people at risk for cardiovascular disease and diabetes. Today we have even better risk calculators, which take other risk factors into account, such as age and activity levels. But you can still pay attention to metabolic syndrome as a way to recognize that trouble is brewing," says Dr. David M. Nathan, a Harvard Medical School professor and the director of the Diabetes Center and Clinical Research Center at Massachusetts General Hospital.
Metabolic syndrome also increases the risk for developing liver disease, kidney disease, or sleep apnea (a condition marked by pauses in breathing during sleep).
What to eat when you have metabolic syndromeHaving metabolic syndrome means you're likely overweight or that you have another condition, such as high blood sugar, cholesterol, or blood pressure, that may be stoked by an unhealthy diet. One of the best antidotes is eating a healthy plant-based diet. Swap junk food for lots of vegetables, fruits, nuts, and whole grains; moderate amounts of fish and poultry; and limited portions of red or processed meats. And do one thing more: "Eat less. If you expend more calories than you're taking in, you'll lose weight," says Harvard Medical School diabetes expert Dr. David M. Nathan. His go-to tricks: eat smaller portions and focus on foods high in fiber (such as vegetables and legumes), which will keep you fuller longer. |
Diagnosis and treatment
You can measure your waist to see if you have at least one metabolic syndrome risk factor. But you can't see the others. So perhaps discuss it at your next doctor appointment, and double-check your annual blood work results.
The good news is that you can reverse metabolic syndrome. Losing weight is central to reducing many of its features. Lowering elevated blood pressure, blood sugar, and cholesterol levels also plays a major role in reducing your risk for heart disease and stroke.
If you can do that and live a healthy lifestyle — exercising daily, eating a healthy diet, getting enough sleep, not smoking, and limiting alcohol intake — you'll not only decrease your risks for heart disease and diabetes, but also increase your odds of living longer.
Image: © adamkaz/Getty Images
About the Author
Heidi Godman, Executive Editor, Harvard Health Letter
About the Reviewer
Anthony L. Komaroff, MD, Editor in Chief, Harvard Health Letter; Editorial Advisory Board Member, Harvard Health Publishing
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