Metabolic Syndrome (insulin resistance)

“Metabolic” refers to the biochemical processes that allows for normal body function. Metabolic syndrome is multiple conditions that have been found to increase the risk of developing heart disease. A person with metabolic syndrome has increased blood pressure, a high blood sugar level, excess body fat around the waist, and abnormal cholesterol levels. This makes them twice as likely to develop heart disease and five times more likely to develop diabetes than someone without it.

What causes metabolic syndrome?

Obesity and inactivity are the main causes. Even one risk factor increases your risk of heart disease and metabolic syndrome requires diagnosis of at least three of these risk factors:

Low HDL cholesterol levels – HDL is the “good” cholesterol that removes bad cholesterol from your arteries.

Excess abdominal fat – Fat in the stomach area is a greater risk factor than fat in other parts of the body.

High fasting blood sugar – An elevated blood sugar may be an early sign of diabetes.

Hypertension (high blood pressure) – Hypertension can damage your heart and cause a plaque buildup, a waxy substance that can narrow your arteries.

High triglyceride level – Triglycerides are a type of fat in the blood.

What are the symptoms of metabolic syndrome?

High fasting blood sugar can cause increased thirst and urination, fatigue, and may be a symptom of diabetes. Most of the other risk factors of metabolic syndrome display no signs or symptoms. A visible sign of excess abdominal fat is increased waist circumference.

How is metabolic syndrome diagnosed?

Metabolic syndrome is diagnosed using a combination of a physical exam and blood test results. Each of the five risk factors can be independently diagnosed.

A low HDL cholesterol level – A blood test can measure your cholesterol levels. An HDL cholesterol level of less than 50 mg/dL (milligrams per deciliter) for women and less than 40 mg/dL for men is a risk factor for metabolic syndrome.

Excess abdominal fat – Your doctor can measure your waist to determine if you have a large waistline. A waist measurement of over 35 inches for women or 40 inches for men is a metabolic syndrome risk factor.

High fasting blood sugar – Blood sugar levels can be measured by a blood test. A fasting blood sugar level between 100 and 125 mg/dL is considered prediabetes, and 126 mg/dL and above is considered diabetes. Both are metabolic syndrome risk factors.

Hypertension (high blood pressure) – A blood pressure screening can diagnose hypertension. A blood pressure level of 130/85 mmHg or higher is a metabolic syndrome risk factor. If even one of these numbers is too high, you’re at risk.

High triglyceride level – A blood test can measure your triglyceride levels. A level of 150 mg/dL or higher is a metabolic syndrome risk factor.

How is metabolic syndrome treated?

Metabolic syndrome can be managed through lifestyle changes and medication, if necessary. To start, your doctor may recommend the following:

Losing weight

Eating a heart-healthy diet

Quitting smoking

Getting daily physical activity

If lifestyle changes aren’t enough, you could be prescribed medication to lower high blood pressure, triglycerides, and blood sugar. Blood thinners may also be prescribed to reduce your risk of blood clots, which are common in people with metabolic syndrome.


Charles A. Shoultz, Jr., M.D., F.A.C.C.   •   Charles A. Shoultz, III, M.D., F.A.C.C.   •   Rodney A. Brown, M.D., F.A.C.C.
William R. Pitts, M.D., F.A.C.C.   •   Donald S. (Buck) Cross, M.D., F.A.C.C. • Andrew K. Day, M.D., F.A.C.C.
Sherwin F. Attai, M.D., F.A.C.C.   •   Shawn J. Skeen, M.D. F.A.C.C.   •   Harvey R. Chen, M.D. F.A.C.C.
Adam M. Falcone, M.D., F.A.C.C.   •   Brian C. Barnett, M.D., F.A.C.C.

Diplomates, American Board of Internal Medicine,
Cardiovascular Disease, Interventional Cardiology, Clinical Cardiac Electrophysiology