Metabolic Syndrome (cont.)
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Metabolic Syndrome Treatment
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Treatment for metabolic syndrome ranges from changes in diet and lifestyle to adminstering cholesterol-lowering and diabetes medications. Goals are to lower blood pressure and control body weight.
Self-Care at Home
Lifestyle modification is the preferred treatment of metabolic syndrome. Weight reduction usually requires a specifically tailored multifaceted program for the patient that includes diet and exercise. Medications may be useful in some instances. As noted above, most people who have metabolic syndrome are overweight and lead a sedentary lifestyle.
A detailed discussion of therapeutic diets and the pros and cons of each diet is beyond the scope of this article. However, one diet that is palatable and easily sustained and has shown benefit is the Mediterranean diet. The Mediterranean diet is rich in olive oil (a "good fat") and contains a reasonable and sustainable amount of protein and carbohydrates. Some studies have suggested that when compared to a low fat diet, people on the Mediterranean diet have had a greater decrease in body weight, greater improvements in lowering blood pressure and cholesterol levels, and improvement in other markers of heart disease; all of which are important in evaluating and treating metabolic syndrome.
A regular and consistent exercise program is also an important lifestyle modification that can be accomplished at home or a gym. Thirty minutes of exercise five days a week is a reasonable start, providing there are no medical contraindications to exercise. (It is prudent to consult your physician prior to starting any exercise program.) Lowering blood pressure and cholesterol levels, along with increasing insulin sensitivity, are beneficial effects of a regular consistent exercise program, regardless of whether weight loss is achieved. Thus, exercise in still a helpful tool in treating metabolic syndrome.
Medical management should be aimed at targeting the components of metabolic syndrome that are present.
If a patient with metabolic syndrome has already had a heart attack, their LDL ("bad") cholesterol should be reduced to a level below 70mg/dl. Lifestyle modifications and medications may both be necessary to achieve this desired reduction.
A person with diabetes has a heart attack risk equivalent to that of someone who has already a heart attack, and should be treated the same as a patient who has had a heart attack. What remains controversial is whether metabolic syndrome should be considered sufficient to raise the risk to this degree. If a patient has metabolic syndrome, a detailed discussion about therapy to reduce blood lipid levels is necessary between the patient and the doctor, as each individual case is unique.
Goals for lowering blood pressure are generally set lower than 130/80. In addition to lowering blood pressure, some blood pressure medications have other effects on the body. For example, ACE inhibitors (a class of blood pressure drugs) has been found to reduce the levels of insulin resistance and thus may slow the development of type 2 diabetes. This is an important consideration when discussing the choice of blood pressure drugs for a patient with metabolic syndrome.
While a healthy body weight should also be a goal of treatment, it is important to remember that a reduction in weight can have a dramatic benefit on lowering blood pressure and cholesterol levels and increasing insulin sensitivity.
Medically Reviewed by a Doctor on 9/10/2014
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