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Primary Prevention of Cardio-Vascular Disease

Definition of the Metabolic Syndrome

The current criteria for the identification of the metabolic syndrome described by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) is any three of the following risk factors:
  • abdominal obesity (>102 cm in men and >88 cm in women),
  • elevated triglycerides (greater than 1.7 mmol/l),
  • low high-density lipoprotein cholesterol (HDL-C) less than 1.0 mmol/l in men and 1.3 mmol/l in women,
  • blood pressure > or = 130/90 mmHg, and
  • fasting glucose > or = 6.1 mmol/l (might be revised down to 5.5 mmol/l) or it might be preferable to include impaired glucose tolerance as a criterion.

However, it is likely that for South Asians the waist/hip ratio is a better measure of obesity then absolute measurement of waist circumference. Truncal obesity may be defined as waist/hip ratio >0.9 in males and >0.8 in females.

CRP levels are increased in those with the metabolic syndrome. Both CRP and the metabolic syndrome increase risk over and above that estimated by the Framingham risk equations. Those with the metabolic syndrome and CRP levels <3mg/dl might still be at the same increased risk of future events as those without the metabolic syndrome with CRP levels over 3mg/dl.

A 7% reduction in body weight might reduce CRP levels by about 27%

Hitesh Patel, Cardiologist
5th June, 2003

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