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Medical Edge Newspaper Column from Mayo Clinic

METABOLIC SYNDROME: A PRECURSOR TO HEART DISEASE

DEAR MAYO CLINIC: I have been diagnosed with metabolic syndrome and was told that it can affect my heart health as much as smoking two packs of cigarettes a day can. What does metabolic syndrome have to do with heart disease?

ANSWER: Metabolic syndrome is a cluster of conditions — high blood pressure, excess fat around the waist (apple-shaped body), low levels of HDL cholesterol (the “good” cholesterol), and high levels of blood sugar and the blood fat called triglycerides — that occur together.

Having just one of these factors increases your risk of heart disease because it will promote hardening of the arteries (atherosclerosis) and the formation of blood clots, both of which contribute to heart attacks. With a combination of factors, your risk is even greater. One study showed that men with three or more metabolic-syndrome components are nearly twice as likely to have a heart attack or stroke and over three times as likely to develop heart disease as are those without any factors.

Underlying practically all of the components of metabolic syndrome is “insulin resistance,” a condition in which the muscle cells need excessive amounts of insulin in order to process blood sugar for energy. The resulting elevated levels of insulin and glucose in the blood interfere with the body’s metabolic processes — raising the levels of triglycerides and other blood fats, for example — and they affect kidney function, leading to increased blood pressure.

Insulin resistance also contributes to narrowing of the coronary arteries, which reduces blood flow; to thickening of the blood, which makes it easier to get blood clots; and to high levels of blood markers of inflammation, which have been linked to an increased risk of heart attack.

The cornerstone of treatment for metabolic syndrome is exercise and diet. For example, getting 30 to 60 minutes of moderate-intensity exercise, such as brisk walking, every day, and losing as little as 5 to 10 percent of your body weight, can pay significant dividends in reducing insulin levels, blood pressure and blood sugar. Such lifestyle changes are important for everyone, but they are even more important for patients with metabolic syndrome.

If you are unable to achieve your goals with lifestyle changes, your doctor may also prescribe medications to lower blood pressure, control cholesterol or help you lose weight. Aspirin therapy may help reduce your risk of heart attack.

Francisco Lopez-Jimenez, M.D., Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.

Additional Resources:
Metabolic Syndrome
News Release: Metabolic Syndrome

READERS: If everyone is mumbling and your partner is complaining about the loud TV volume, perhaps your hearing isn’t what it once was.

Roughly one-third of Americans over age 60 and 40 to 50 percent of adults 75 and older have hearing loss.

Even though it’s common, some people are reluctant to deal with their hearing loss because of embarrassment or worry about seeming old. But if you suspect hearing loss, the most important thing you can do is see a doctor or an audiologist.

An audiologist can assess your hearing loss and measure the severity through various tests. Factors that contribute to hearing loss include aging, loud noises, heredity, certain medications and some illnesses. Often, hearing loss identified early can be helped.

Hearing aids may be recommended. Many of today’s hearing aids are substantially better than those your parents or grandparents may have worn. Some fit discretely behind your ear. Others fit inside your outer ear or in the ear canal.

Other listening devices can help you use the telephone or better hear the TV or stereo. These communication aids aren’t meant to replace hearing aids but they can enhance your hearing in certain situations.

If your hearing loss is too severe for hearing aids, you may be a candidate for a cochlear implant — a small electronic device that the surgeon places in your inner ear. It doesn’t restore normal hearing but it can help you be more aware of your surroundings and better understand speech.

Additional Resources:
Treatment of Hearing Disorders
News Release: Facing Facts about Hearing Loss

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.