26
Sep
Two decades ago heart attacks were seen in persons above 50 yrs of age. Currently 25% of heart attacks in India are seen in individuals who are less than 40 yrs of age. Now 15 to 20 % of sudden cardiac death are seen in individuals less the 50 yrs of age. Indians develop heart disease 5 to 10 yrs earlier than the western population. The reason for this change is ‘ Metabolic syndrome’ which we Indians are genetically predisposed to in addition to the drastic change that has occurred in our lifestyle. This is the reason why young people are getting heart attack. But the good news is that all this is preventable with lifestyle changes.
The presence of any three qualify for the diagnosis of metabolic syndrome –
- waist circumference ≥ 90 cm in males and ≥ 80 cm in females
- Triglycerides ≥150 mg/dL or treatment for elevated triglycerides
- HDL cholesterol <40 mg/dL in men or <50 mg/dL in females, or treatment for low HDL
- Systolic blood pressure ≥130, diastolic blood pressure ≥85, or treatment for hypertension
- FPG ≥100 mg/dL or previously diagnosed type 2 diabetes
Prevalence of Metabolic Syndrome –
| Males | 44% |
| Females | 41% |
| 20–39 years | 19.5% |
| > 60 years | 48.6% |
Risk factors for Metabolic Syndrome-
- Diet high in refined carbohydrates & unhealthy fats.
- Physical inactivity/ sedentary lifestyle.
- Post-menopause.
- High stress.
- Parental history of MS.
- Antipsychotic medications.
Metabolic syndrome related disorders-
- Atherosclerotic cardiovascular disease(ASCVD)
- Coronary heart disease manifested by heart attack.
- Cerebrovascular disease manifested by brain stroke.
- Peripheral artery disease manifested by leg pain, ulcers, infection and later gangrene.
- Aortic atherosclerosis and thoracic or abdominal aortic aneurysm which may rupture.
- Others-
- Type 2 diabetes.
- Fatty liver,cirrhosis & Liver cancer and liver failure.
- Chronic kidney disease and kidney failure.
- Polycystic ovary syndrome(also known as poly endocrine metabolic ovarian syndrome.)
- Obstructive sleep apnoea.
- Cognitive decline and dementia.
- Type 2 diabetes.
PREVENTION of Metabolic Syndrome-
- lifestyle modification –
- diet(reduce refined carbohydrates, increase lean protein intake, consume healthy fats** increase fibre intake)
- exercise( walking,cardio and resistance training)
- sleep hygiene.
- avoid alcohol.
- avoid tobacco.
- reduce stress
- Treat cardiovascular risk factors if they persist despite lifestyle change. Consult your doctor for
- Hypertension.
- Diabetes.
- High triglyceride.
- High cholesterol.
- Obstructive sleep apnea.
- Insomnia.
Cardiovascular risk assessment-
We assess the patient’s risk of ASCVD with’PREVENT CALCULATOR* to perform quantitative 10-yr risk estimate for heart attack/ heart failure.
( data required for risk evaluation- age,sex,hight, weight, lipid profile, renal profile, HbA1c,systolic BP, any medications for HT, DM, cholesterol)
Risk interpretation –
| < 5% | Low Risk |
| 5% – 7.4% | Borderline Risk |
| 7.5% – 19.9% | Intermediate Risk |
| > 20% | High Risk |
- Begin ASCVD risk evaluations at 18 years of age.
- low (<5 %) or borderline (5-7.4 %) risk – reassess risk every five year.
- intermediate risk (7.5-19.9%) -reassess risk annually.
- high risk ( > 20% )- investigate and treat.
PREVENT CALCULATOR is available on Google.
Healthy fats –
- Monounsaturated fats & polyunsaturated fats-nuts, seeds, avocado, olive oil, canola oil,sesame oil.
Unhealthy fats-
- Saturated fats – beef, bacon, sausage, hotdogs, palm oil, coconut oil, cotton seed oil, full fat dairy, palm kernel.
- Transfat – deep fried foods, commercial bakery products, frozen dinners, margarine, butter, cheese, egg yolk.
*The opinion expressed in the Blog is of Dr Vijay D’Silva
The information provided in the blog is for educational purpose only and does not substitute for professional medical advice, diagnosis or treatment.
Do not ‘self-diagnose/ treat’.
Consult a qualified medical professional for opinion and treatment.
