Fast Five Quiz: How Much Do You Know About Metabolic Syndrome?

Romesh Khardori, MD, PhD

Disclosures

June 27, 2018

The initial management of metabolic syndrome involves lifestyle modifications, including changes in diet and exercise habits. Indeed, evidence exists to support the notion that the diet, exercise, and pharmacologic interventions may inhibit the progression of metabolic syndrome to diabetes mellitus.

Treatment of associated obstructive sleep apnea may play a significant role in the management of metabolic syndrome. In one study, patients with at least moderate obstructive sleep apnea who used continuous positive airway pressure (CPAP) therapy for 3 months showed significant improvements in their metabolic profile, including reductions in systolic and diastolic blood pressure, low-density lipoprotein cholesterol (LDL-C) level, triglyceride level, and glycated hemoglobin level. Furthermore, reversal of metabolic syndrome occurred to a greater degree in the CPAP therapy group than in patients who underwent sham treatment (13% vs 1%, respectively).

At present, no surgical interventions for metabolic syndrome have been widely accepted. However, trials of bariatric surgery in patients who were morbidly obese and had metabolic syndrome suggested beneficial results, including decreased insulin resistance and lower levels of inflammatory cytokines.

Treatment of hypertension had been based on the recommendations of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines, to achieve a goal blood pressure of less than 140/90 mm Hg or, in patients meeting diagnostic criteria for diabetes mellitus, less than 130/80 mm Hg. However, the 2014 report of the Eight Joint National Committee led to less stringent recommendations for drug therapy (140/90 mm Hg for most populations, 150/90 mm Hg for patients aged 60 years or older), with continued emphasis on the importance of promoting healthy diet and exercise behaviors, as addressed by 2013 guidelines from the American College of Cardiology. Nevertheless, more recent study data continue to support a more aggressive blood pressure goal of 120/80 mm Hg.

For more on the treatment of metabolic syndrome, read here.

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