How does metabolic syndrome affect the risk for coronary artery disease (CAD)?

Updated: Mar 30, 2020
  • Author: F Brian Boudi, MD, FACP; Chief Editor: Yasmine S Ali, MD, MSCI, FACC, FACP  more...
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Metabolic syndrome is characterized by a group of medical conditions that places people at risk for both heart disease and type 2 diabetes mellitus. In the Kuopio Ischemic Heart Disease Risk Factor Study, patients with metabolic syndrome had significantly higher rates of coronary, cardiovascular, and all-cause mortality. [43]

People with metabolic syndrome have 3 of the following 5 traits and medical conditions, as defined by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) Cholesterol Education Program (CEP) [44] :

  • Elevated waist circumference - Waist measurement of 40 inches or more in men, 35 inches or more in women

  • Elevated levels of triglycerides - 150 mg/dL or higher or taking medication for elevated triglyceride levels

  • Low levels of HDL (high-density lipoprotein) or good cholesterol - Below 40 mg/dL in men, below 50 mg/dL in women, or taking medication for low HDL cholesterol level

  • Elevated blood pressure levels - For systolic blood pressure, 130 mm Hg or higher; 85 mm Hg or higher for diastolic blood pressure; or taking medication for elevated blood pressure levels

  • Elevated fasting blood glucose levels - 100 mg/dL or higher or taking medication for elevated blood glucose levels [44] (Note: The American Association of Clinical Endocrinologists, the International Diabetes Federation, and the World Health Organization have other, similar, definitions for metabolic syndrome.)

Although high consumption of carbohydrates and sugar is associated with higher rates of cardiovascular disease risk in adults, not much is known about the effect of added sugars in US adolescents. [45] A study of the National Health and Nutrition Examination Survey (NHANES) 1999-2004, suggests that added sugar consumption is positively associated with an increase risk of cardiovascular disease in adolescents. The results of this study suggest that future risk of cardiovascular disease may be reduced by minimizing sugar intake.

A meta-analysis of multiple population studies associated chocolate consumption with a substantial risk reduction (approximately 30%) in cardiometabolic disorders, including coronary disease, cardiac deaths, diabetes, and stroke. [46] The apparent benefits of chocolate may accrue from a beneficial impact of polyphenols present in cocoa products that increase the bioavailability of nitric oxide. These findings are based on observational studies, and further experimental studies are warranted to confirm the finding of a potential beneficial effect of chocolate consumption.

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