New Paradigm of CardioMetabolic Syndrome - Mother of all diseases

FIGURES: VICIOUS CYCLE OF CARDIO-METABOLIC SYNDROME

HOW'S YOUR MEASUREMENT?

OBESITY: waist circumference > 40 inches men

    waist circumference > 35 inches in women

LDL > 2.6mmol/L

HDL <>

TG > 1.9mmol/L

Blood Pressure >130/90 mmHg

Fasting Blood Sugar > 6.1mmol/L

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INTERVENTIONS?

1) LIFESTYLE MODIFICATIONS

-STOP SMOKING

-EXERCISE, EXERCISE, EXERCISE

-MORE VEGE LESS RED MEAT

-LESS SUGAR

-LESS FAT

-LESS SALT

2) ROLE OF ANTIHYPERTENSIVE

-ESPECIALLY RAS BLOCKADE (IE ACE INHIBITOR, ARB, CCB)

-?DIURETICS INCRESES RISK OF DIABETES ONSET?

3) LIPID LOWERING DRUGS

-FIBRATES & NICOTINIC ACID FOR HIGH TG

-STATINS FOR THE REST

-EXERCISE FOR HDL :-) ops not a drug its a STYLE OF LIFE

4) INSULIN SENSITISER

-METFORMIN, ACARBOSE, THIAZOLIDINDIONES

-?ROSIGLITAZONE ON CARDIAC OUTCOME

5) ANTIOBESITY DRUGS

-SIBUTRAMINE (affecting monoaminergic system)

- ORLISTAT (gastrointestinal pancreatic lipase inhibitor)

- RIMONABANT (endocannabinioid, CB1 receptor antagonist)

6) ANTITHROMBOTIC DRUGS

-insulin resistance promotes pro-thrombotic states (coagulation vs fibrinolysis system)

-LOW DOSE ASPIRIN / CLOPIDOGREL

7) ?ANTI-INFLAMMATORY DRUGS

-insulin resistance recognised as inflammatory disease

-CRP + PLASMINOGEN ACTIVATOR INHIBITOR 1 & IL-6 HIGH CONCENTRATION

references:

1) DASH TRIALS

2) MEDITERRANEAN DIET

3) ATP III GUIDELINES & IDF GUIDELINES

4) ESH/ESC GUIDELINES

5) ASCOT TRIAL

6) The Rimonabant In Obesity (RIO) program

7) ATHEROGENIC DIET

NOTES:-

1) PREDIABETES STATE

2) AN APPLE A DAY KEEPS YOUR DOC AWAY STILL HOLDS TRUE

3) TO TACKLE THIS MOTHER OF ALL DISEASE IS TO KEEP YOUR BUTT OFF YOUR CHAIR/ COUCH

4) CUT DOWN ON SIMPLE CARBOHYDRATE/ FATTY FRIED FOOD