Open AccessDrugs Are Not Enough: The Metabolic Syndrome—A Call for Intensive Therapeutic Lifestyle Change
Author(s) -
Brown Todd M.,
Sanderson Bonnie K.,
Bittner Vera
Publication year - 2009
Publication title -
journal of the cardiometabolic syndrome
Language(s) - English
Resource type - Journals
eISSN - 1559-4572
pISSN - 1559-4564
DOI - 10.1111/j.1559-4572.2008.00031.x
Subject(s) - medicine , metabolic syndrome , hypertriglyceridemia , national cholesterol education program , coronary artery disease , waist , diabetes mellitus , cholesterol , endocrinology , triglyceride , obesity
Whether intensive pharmacologic cardiovascular risk factor management reduces metabolic syndrome (MetS) prevalence is unknown. The authors compared the number of secondary prevention medications and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)–defined MetS prevalence in coronary artery disease patients entering cardiac rehabilitation from 1996 to 2001 (period 1, n=516) with those entering from 2002 to 2006 (period 2, n=609). Age, sex, and ethnicity were similar in both periods. From period 1 to period 2, participants took more secondary prevention medications (2.8±1.3 vs 3.5±1.0, P<.001). Prevalence of low high‐density lipoprotein cholesterol (66% vs 66%), diabetes (37% vs 38%), and hypertension (81% vs 81%) were unchanged. The prevalence of hypertriglyceridemia decreased (48% vs 36%, P<.001), but the proportion meeting criteria for elevated waist circumference increased (51% vs 58%, P<.05), resulting in no change in overall MetS prevalence (60% vs 59%, P=NS). More emphasis on therapeutic lifestyle change in addition to intensive pharmacologic therapy is needed to reduce MetS prevalence in patients with coronary artery disease.