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Metabolic Syndrome : The Silent Killer

Metabolic syndrome could be the leading killer in the coming years.

One out of every third Indian is suffering from one or other form of heart diseases or 30 million heart patients in India. If the current trend continues, by 2020, India will have the highest burden of atherothombotic cardiovascular diseases and surpass any other country in the world.

The growth of heart diseases is dependent on a number of interlinked factors such as ageing, changing lifestyles, bad eating habits and rapidly evolving socio-economic determinants like access to healthcare.

Heart disease is not a phenomenon in urban areas – of the 30  million total heart patients, 16 million are from rural areas of India.

“One out of every third Indian is suffering from one or other form of heart diseases or 30 million heart patients in India. If the current trend continues, by 2020, India will have the highest burden of atherothombotic cardiovascular diseases and surpass any other country in the world.”

India’s rural population and urban poor are facing a double burden –increasing incidence of acute diseases, and rapid growth of chronic diseases.

Indian hospitals perform one of the highest open heart surgeries in the world a year – 2 lakh. This is steadily increasing with an annual rise to the tune of 25-30 per cent in the case of coronary interventions over the past several years.

World over, heart diseases claims 17.3 million lives year, a major cause of death. India is no far behind.

One of the major reasons for increase in coronary heart diseases in India is metabolic syndrome. Metabolic syndrome, also known as dysmetabolic syndrome – a cluster of conditions that lead to heart diseases. The main features of metabolic syndrome includes insulin resistance, hypertension or high blood pressure, abnormal cholesterol, and an increased risk for clotting.

Metabolic syndrome causes a group of risk factors that raises the risk level for heart disease, diabetes and stroke as well. The term “metabolic” refers to the biochemical processes involved in the body’s normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease.


Insulin Resistance

Insulin is a hormone produced by pancreas. Pancreas release the insulin into the blood stream and it is an essential hormone for many metabolical actions in the body like control of carbohydrates, regulation of functions of body cells, including growth.

If at any point of time, the body cells refuse to obey the commands of insulin, it will affect the corresponding functioning of several organs, including kidney, heart and body cells. Insulin resistance is a condition in which the body cells becomes resistant to the effects of insulin. In other words, the normal response to a given amount of insulin is reduced. As a result, higher levels of insulin are needed for insulin to have proper effects. So, the pancreas produces more insulin. When the response to natural insulin is reduced, external or artificial insulin is administered to maintain the functioning of various organs of the body.

Insulin resistance leads to a stage, when pancreas can no longer produce sufficient insulin for the body’s demands. It is at this stage, the blood sugar rises. Thus two major diseases that result from Insulin resistance is diabetes and heart diseases.

What are the causes of insulin resistance? There are several – genetic or inherited, which is a major cause of Insulin resistance. The other causes are, excess weight, especially around the waist, high blood pressure and higher levels of cholesterol and triglycerides in the blood, obesity, pregnancy, infection or severe illness, stress, inactivity and excess weight, excessive steroid use.

Hypertension or high blood pressure

Hypertension is a maor public health problem in India. A recent study by Lancet based on analyses of 0.6 million (5,54,146) ailments reported in 0.2 million (2,04,912) patients’ visit revealed that hypertension is the most common diagnosis reported in India.

About 33% urban and 25% rural Indians are hypertensive. Of these only one tenth of the rural and one-fifth of urban Indian hypertensive population have their BP under control as only 25% of the rural and 38% of urban population with BP are being treated for hypertension.

Hypertension or high blood pressure is defined as high pressure or tension in the arteries that carry blood from the heart to the rest of the body. Blood pressure is indicated by two numbers – the systolic blood pressure (the higher number), equals the pressure in the arteries as the heart contracts and the diastolic pressure (the lower number) is the pressure in the arteries as the heart relaxes. The normal blood pressure is below 120/80, while between 120/80 and 139/89 is called ‘pre-hypertension’ and a blood pressure of 140/90 or above is considered high. Systolic blood pressure of about 90 to 100 is considered low blood pressure.

Complications in blood pressure include heart disease, kidney (renal) disease, hardening of arteries, eye damage and stroke (Brain damage).


Cholesterol is a soft, waxy substance found in the bloodstream and the body cells. It is important to overall health. However, not all cholesterol are good. There is good cholesterol, which the body needs in ample supply and bad cholesterol, which should be kept to a minimum. People with diabetes are more prone to bad cholesterol, which contributes to cardiovascular diseases. Triglyceride is the common type of fat in the body. Normal levels of the fat vary by age and sex. A high triglyceride level combined with low HDL (good) cholesterol or high LDL (bad) cholesterol levels could lead to build up of fatty deposit in artery walls, increasing the risk of heart attack and stroke.

Diabetes tends to lower “good” cholesterol levels and raise triglyceride and “bad” cholesterol levels, which increases the risk for heart attack and stroke. This common condition is called diabetic dyslipidaemia.

Studies show a link between insulin resistance, which leads to type 2 diabetes and diabetic dyslipidaemia, atherosclerosis and blood vessel disease.

Metabolic syndrome and Obesity

If diabetes was the central factor to metabolic syndrome in the eighties, presently it is obesity.

“The more recent definition by IDF (International Diabetes Federation) focuses on obesity as the central factor if at least other elements of dyslipidaemia, hypertension and hyperglycaemia are present, and where insulin resistance is no longer even a part of the syndrome,” says an editorial of international publication Diabetology & Metabolic Syndrome

Metabolic syndrome is becoming more common due to a rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease.

It is possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome requires long-term effort and teamwork with health care providers.




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