A Prospective Study on Metabolic Syndrome in Patients with Cardiovascular Disease.

Joel, Varghese (2012) A Prospective Study on Metabolic Syndrome in Patients with Cardiovascular Disease. Masters thesis, KMCH College of Pharmacy, Coimbatore.

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The aim of the study was to assess the prevalence of the MetS among patients with CVD using the revised National Cholesterol Education Program Adult Treatment Plan III (rNCEP ATP III) and International Diabetes Federation (IDF) definitions. STUDY DESIGN: A prospective observational study was conducted in the outpatient Department of Cardiology, Kovai Medical Center and Hospital, a multispecialty hospital in Coimbatore. It was approved by the KMCH ethics committee for research at Kovai Medical Center and Hospital, Coimbatore on 22-10-2011. STUDY SITE: The study was conducted in the outpatient Department of Cardiology, Kovai Medical Center and Hospital, a multi-specialty hospital in Coimbatore. STUDY PERIOD: The study was carried over a period from June 2011 to December 2011 in Kovai Medical Center and Hospital, Coimbatore. INCLUSION CRITERIA: Both male and female patients having CVD were included in the study. EXCLUSION CRITERIA: Pregnant women and patients with abdominal ascites were excluded from the study. Conclusion: The Indian subcontinent is undergoing epidemiological evolution as non-communicable ailments like Coronary Heart Disease (CHD) and Type 2 Diabetes Mellitus (T2DM) are rapidly replacing infections as the primary cause of morbidity and mortality. India has developed into the “Diabetes Capital” of the globe and by the year 2020, is expected to have the maximum number of individuals suffering from cardiovascular disease (CVD) (Yusuf S, Ounpuu S., 2001). Approximately 7.8% of the United States (U.S) population has Diabetes Mellitus (DM), and it is expected that the number of patients with DM will increase to 48.3 million by 2050 in the U.S. and to 300 million worldwide in the year 2025, representing a 122% rise compared with 1995. Even though the traditional cardiovascular jeopardy factors (e.g., smoking and hypertension) are becoming more efficiently managed, a permanent increase of the so-called “cardiometabolic risk” is prominent. Early from this century, the nomenclature “Metabolic Syndrome (MetS)” has become more accepted to recognize a cluster of disorders together with obesity, dyslipidemia, hypertension, and insulin resistance. It is the most important risk factor for CVD and DM in both genders. Global cardiovascular jeopardy is the likelihood of affliction of a coronary episode or stroke deriving from risk factors including metabolic factors (total cholesterol, high-density lipoprotein cholesterol (HDL-c), blood glucose), hemodynamic factors (blood pressure), and lifestyle factors (exercise, smoking), all changeable ahead of those nonmodifiable ones such as age and gender. Ongoing investigation is required to determine how best to define the MetS. Although it is clear that the presence of the syndrome is associated with increased cardiovascular risk, the levels of associated risk have not been clearly defined. Different projected definitions would appear to result in diverse predictions of risk and appears to vary according to which components of the proposed definitions are present. Imam et al., reported a prevalence of 79.7% from Pakistan, Bruno et al., reported a prevalence of 75.6% from the USA and Foucan et al., reported a 77% prevalence of the MetS in diabetic Indian immigrants in the USA. This prospective study revealed the prevalence rate of the MetS in Outpatient Department of Cardiology clinics among patients with CVD using the IDF criteria as 41.1% and with revised National Cholesterol Education Program Adult Treatment Plan III (rNCEP ATP III) criteria as 44.4%. When studying prevalence among the genders, females were more prevalent to the syndrome than males which give an inference that females with MetS are prone to CVD and other co-morbidities. But there were no significant differences in the cardiometabolic variables, laboratory variables, hemodynamic variables and physical variables among male and female. The findings from our study showed that the prevalence of the MetS increases with age. The prevalence of the MetS in our subjects is high in both genders and increases with age thus posing a latent high cardiovascular risk. The imperative clinical effect of the MetS was CVD. Also the risk for T2DM is higher, and thereby DM is a foremost risk factor for CVD. Overall, MetS was related with a twofold increase in the risk of CVD and stroke, and a 1.5-fold increase in risk of all-cause mortality. Accordingly, individuals with MetS are at higher risk for cardiovascular outcomes than for allcause mortality, although these patients are at elevated risk for either outcome compared with those without this syndrome. The alarming increase in obesity especially its central component consequential in MetS, seems to be behind the twin pandemic of CVD and T2DM currently sweeping the Indian subcontinent. From our study it was revealed that sedentary life-style and increased popularity and easy-availability of energy-dense food are the dynamic force for this increasing hazard. It was found that in people without the syndrome has atleast one component of MetS and may therefore be at an increased risk of cardiometabolic syndrome. And therefore community based programmes to promote healthy living are needed to embark upon this catastrophe. Physicians along with pharmacist and other healthcare professionals have a very important role to play in this endeavor. Therefore larger prospective studies in other parts of India are necessary to recognize the prevalence of the MetS along with the risk factors associated in cross sectional population and in specific groups of high-risk patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Metabolic Syndrome; Cardiovascular Disease
Subjects: PHARMACY > Pharmacy Practice
Depositing User: Ravindran C
Date Deposited: 16 Oct 2017 05:31
Last Modified: 16 Oct 2017 05:31
URI: http://repository-tnmgrmu.ac.in/id/eprint/3681

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