If you have high blood pressure, this could be part of a condition known as metabolic syndrome, which affects as many as one in three adults. Having metabolic syndrome has been described as a ‘cardiovascular time-bomb’ as it doubles your risk of a heart attack or stroke, increases your chance of developing type 2 diabetes by a factor of five, and is associated with kidney failure and certain cancers. Making diet and lifestyle changes can reverse metabolic syndrome, however, and improve your blood pressure control.
What is metabolic syndrome?
Metabolic syndrome is diagnosed when you have a combination of any three of the following:
- a high blood pressure (130/85 mmHg or greater)
- raised triglyceride levels (greater than 150 mg/dl (1.7 mmol/L)
- low levels of ‘good’ HDL-cholesterol (less than 40 mg/dL or 1.03 mmol/L for men, less than 50 mg/dL or 1.29mmol/L for women)
- high fasting blood glucose levels (100 mg/dL or 5.6 mmol/L or higher)
- abdominal obesity (BMI over 30 Kg/M2 or an increased waist circumference: 80 cm or more for females, 94 cm or more for Caucasian males, and 90 cm or more for South Asian or Chinese males).
Metabolic syndrome symptoms
In most cases, having metabolic syndrome causes no obvious symptoms except for increasing weight gain, lack of fitness and fatigue. High blood pressure and raised blood fat levels do not usually cause symptoms, but if your blood glucose levels are rising you may develop recurrent urinary infections, thrush (Candida) or skin boils.
Metabolic syndrome causes
The main underlying causes of metabolic syndrome is obesity and an associated insulin resistance, in which your muscle and fat cells lose their sensitivity to insulin hormone.
The tendency towards insulin resistance may be inherited, associated with other health conditions such as polycystic ovary syndrome, or acquired due to lifestyle factors such as obesity, lack of exercise or eating excessive carbohydrates.
When you eat too many foods that raise blood sugar levels, your pancreas has to make more and more insulin hormone to escort the excess glucose into your fat cells for storage. This leads to overweight, which is especially harmful for those who store fat around their waist, rather than their hips.
Metabolic syndrome is strongly associated with storing fat around your middle. Fat cells that become packed around your internal organs are more active than those stored under your skin. They produce hormones and ‘leak’ fatty acids into the circulation which travel directly to the liver, to switch on genes that increase the production of non-HDL cholesterol, clotting factors and inflammatory substances, and impair glucose control.
Fatty acids that leak from abdominal fat can overwhelm your liver, causing fat to accumulate in the form of non-alcoholic fatty liver disease (NAFLD). One in five people with NAFLD develop liver inflammation (non-alcoholic steatohepatitis, or NASH) which can lead to liver cirrhosis, in which liver cells are damaged and liver function impaired. It is therefore a condition that is taken seriously.
Metabolic syndrome treatment
If you think you could have metabolic syndrome, see your doctor for a check-up to assess your blood pressure, cholesterol balance, triglyceride and glucose levels. Your doctor may need to prescribe a number of drugs to improve your health, and it is important to take these as prescribed.
While you may need medication initially to correct your blood pressure, you can reverse metabolic syndrome by losing weight, following a lower glycemic index diet or DASH diet, and increasing your level of exercise.
Recognising that you have metabolic syndrome is important, as it is associated with a number of clinical findings which, together, dramatically increase your future risk of coronary heart disease and stroke. In addition, 80% of people with metabolic syndrome go on to develop type 2 diabetes if they do not modify their diet and lifestyle.
Losing just 4 Kg in excess weight can make a significant difference. Losing 10 Kg (22 lb) in excess weight can:
- Lower your blood pressure by 10/20 mmHg
- Improve your blood glucose control by 50%
- Reduce your blood levels of triglyceride fat by 30%
- Increase your levels of ‘good’ HDL-cholesterol by at least 8% and lower levels of non-HDL cholesterol by 15%.
Regular exercise (30 to 60 minutes per day, on most days) will burn excess glucose and fatty acids as fuel, to improve your blood test measurements, lower your blood pressure and promote weight loss, as well as increasing your overall fitness. A number of studies now confirm that diet and lifestyle changes can halve the chance of developing type 2 diabetes in those who are overweight with impaired glucose tolerance.
Read more information about diet and metabolic syndrome here.
If your blood pressure is raised, self-monitoring is key to maintaining good control.
Click here for advice on choosing a blood pressure monitor to use at home.