Its important for patients and physicians to understand the CARDIOMETABOLIC SYNDROME. We are learning that many illnesses and conditions are not isolated, not just one-of single problems. Instead, many conditions such as obesity and high blood pressure and stress, actually aggravate and provoke each other. The grouping, the cluster of these conditions which act and worsen each other, is what we call the CARDIOMETABOLIC SYNDROME.
Why is this important?
THE CARDIOMETABOLIC SYNDROME IS A PACKAGE OF CONDITIONS THAT MAKE EACH OTHER WORSE.
Patients with THE CARDIOMETABOLIC SYNDROME are at much HIGHER RISK for many serious conditions.
CARDIOMETABOLIC SYNDROME puts people much higher risk for heart attacks, strokes, complications of diabetes, and sudden cardiac death.
We must try to address all the aspects of CMS at once. It is not enough, for example, to chase only high blood pressure, or to chase only high sugar levels; we must, instead, try to offer solutions and medications that have a global benefit, a holistic benefit, to the whole person. Otherwise, the benefit of treating one condition may be cancelled out by another condition getting worse.
The list of conditions that mutually reinforce each other is always expanding. It includes:
Fat in the Abdomen is dangerous. It acts like an independent organ that makes chemicals that accelerate many problems. This is what I call the CardioMetabolic Soupthe collection of chemicals that abdominal fat pours out that worsens blood pressure, cholesterol, diabetes, and so on.
Remember, Abdominal Fat is metabolically, chemically, active and dangerous.
High Blood Pressure
The silent, ticking time bomb. One of the problems in high blood pressure patients, in hypertensive patients, is what doctors call the activation of a blood pressure control system in the body called the RAASystem, formally known as the Renin-Angiotensin Aldosterone System. When this RAASystem is activated, people are at accelerated risk for heart attacks, strokes, kidney failure, and so on.
Hugely important as the building block of plaque, of atherosclerosis, of hardened arteries, of the pipes getting blocked. The specific abnormalities include making the bad LDL cholesterol even worse; lowering the good HDL Cholesterol; and raising another type of fat found in the blood called Triglycerides.
Several of the chemicals that Abdominal pours out makes your body ignore its own insulin. This is called Insulin Resistance. Your body resists the effects of its own Insulin. So sugars stay high, and patients open themselves up to the many complications of diabetes, which include diseases of the
Protein in the Urine
This is known as Microalbuminuria. Spilling protein in the urine is a very important marker, a very important way for doctors to monitor your risk for Heart disease. When the kidneys are overwhelmed, when there is damage in the kidney tissue which allows this protein, this meat, to escape, it means there are problems all over: in the heart, brain, sex organs, and so on.
Poorly Functioning Blood Pipes
This is known as Endothelial dysfunction. The inner lining of blood vessels, of the pipes, is a thin layer of cells known as the Endothelium. When this does not work properly, then our arteries and blood vessels work all uncoordinated. This accelerates the chances of having many cardiovascular problems. The arteries then tighten, they stiffen, they become less resilient, the insides become worn and full of microtears, and that can lead to clots, blockages, and explosions.
Known as the ProInflammatory state, this means that the body goes to War with itself, starts suffering Friendly Fire. There are many cells and chemicals in the body which are meant to attack outside invaders like small debris and bacteria. But these defenses attack the host. This also accelerates the chances of having many cardiovascular problems.
Promoting Blood Clotting
Known as the ProThrombotic state, or the Hypercoagulable state, the body promotes clotting. Clotting is usually to happen at the site of an injury or cut, even at the microscopic level. But with Blood clotting promoted, extra harmful clots form throughout the blood vessels. This also accelerates the chances of having many cardiovascular problems.
High Uric Acid count in the blood
Known as Hyperuricemia, this means high URIC ACID in the blood stream. This can can lead to Gouty arthritis, as well as contribute to forming Kidney stones.
It is becoming clearer that the CardioMetabolic Syndrome affects Mood, how you feel, energy levels, and may set people up for getting DEPRESSION. Mood effects happen from many causes, but hormones such as Testosterone and Estrogen are also involved.
These are the leading items of the CARDIOMETABOLIC SYNDROME, but there are many others.
Heart disease is still Canadas number one killer. What doctors regret is that most heart attacks could have been prevented. But people still are not getting the message.
Learn your risks.
Take appropriate action. This will include getting yourself fully tested, and will likely include taking particular medications to protect yourself.
TAKE THIS MESSAGE TO HEART.
Dr. Shafiq Qaadri is a Toronto family physician and Continuing Medical Education lecturer. www.doctorQ.ca