Past two decades allowed a sharp decline in deaths from cardiovascular disease. But today, the mortality decline more… According to some experts, this trend would have an origin: the metabolic syndrome. Zoom on a silent enemy.
Ahead of cancer, cardiovascular disease is responsible for 17 million deaths each year. In France, it is the first cause of mortality with 180,000 deaths a year. While the current policies seem to mark the steps, the discovery of a new enemy could revive the fight against this scourge.
Cardiovascular mortality drop more!
No fewer than 120,000 people are treated each year for myocardial infarction and 130 000 for a stroke. And 20 million people are affected by these diseases prevention approaches. The origin of this carnage, the risk factors are identified: tobacco, physical inactivity and obesity, high blood pressure, diabetes mellitus, too high levels of lipids – fat – in the blood that is.
Since the 1960s, taking account of these parameters allowed significant progress against cardiovascular disease. The arrival of drugs more more effective and better therapeutic strategies better codified in helped to reduce cardiovascular mortality by more than 50% in many developed countries. But since the 1990s, the efforts of prevention and therapeutic innovations appear to mark the steps and figures are stagnating.
Not limited to the part of the iceberg
Several experts for1, the root of evil has a name: the syndrome X or metabolic syndrome. Beyond the well known aggravating factors, this clinical concept appears as a revolution in patients at risk and perhaps setting in the management of cardiovascular disease. The clinical definition of the metabolic syndrome is based on five parameters, but the presence of three is sufficient for the diagnosis:
-Waist circumference > 102 cm in men and > 88 cm in women – to modulate according to ethnic group.
-HDL (good cholesterol) < 40 mg/dl for men and < 50 mg / dl in women (or treatment); -Triglycerides > 150 mg/dl (1.7 mmol/L) (or treatment);
-Fasting glucose > 1 g/dl (or treatment);
-Voltage > blood pressure 130-85 mm Hg (or treatment).
Overweight is more often characterized by waist circumference by body mass index. The problem is that this syndrome does not match one of the currently popular elements. It is more than the sum of these non-pathological disturbances that will be the risk factor. Thus, instead to diagnose and to support isolation factors (obesity, diabetes, hypertension, Dyslipidemia), metabolic syndrome would intervene upstream a transversal and multi-disciplinary approach.
A threefold increase in cardiovascular risk
Recent studies have, in fact, demonstrated that, in these patients with the Metabolic Syndrome, the probability of occurrence of a cardiovascular accident is multiplied by 2 to 4, compared to a population that is free2.3. Too large physical inactivity and inadequate diet are the main culprits of the evolution of the epidemic of obesity and diabetes in Western societies.
Following the same trend, our way of life should lead to a real boom of this metabolic syndrome. In the United States, 20 to 25% of the North American population are affected4. In the more than 50 years, the proportion would be most important for 40 percent of the senior Americans. In Europe, the figures have not yet reached such proportions but are still 15%5 but nearly 30% for senior citizens.