Clinical team approach reduces cardiovascular risk

Researchers at the Medical College of Wisconsin say a multidisciplinary clinical approach to caring for obese patients with metabolic syndrome could swiftly and significantly lower their heart disease risk. The research found that such care could lower patients' 10-year risk for cardiovascular disease by nearly 20% within six months.

"This study highlights the benefits of a clinic that specializes in the needs of obese patients with metabolic syndrome," said lead researcher Safak Guven, MD, assistant professor of medicine at the medical college and clinical director of the obesity/metabolic syndrome clinic at Froedtert Hospital, a major medical college teaching affiliate, in collaboration with the University of Wisconsin School of Pharmacy. "Metabolic syndrome affects approximately 24% of the U.S. adult population. About 47 million people have metabolic syndrome, including 44% of those ages 50 and older. Metabolic syndrome without Type 2 diabetes significantly increasers the risk of coronary heart disease."

Guven said the study could also help establish national clinical standards of care for metabolic syndrome, and accreditation for clinics treating this rapidly emerging problem. "Studies have shown that patients with metabolic syndrome are 1.5 times at greater risk for coronary heart disease," he said. "On the other hand, women in reproductive ages with metabolic syndrome are prone to have polycystic ovarian syndrome, which also puts them at risk for fertility issues. In other words, your waistline now has a significant impact on your lifeline."

Metabolic syndrome is defined as a dangerous constellation of problems occurring in abdominally obese insulin-resistant patients, with or without Type 2 diabetes, and having any of several conditions, including cholesterol abnormalities, hypertension, clotting, or inflammatory protein factors in their blood. This leaves them extremely vulnerable to cardiovascular diseases caused by plaque deposits, including coronary and/or peripheral artery disease and stroke.

Guven and his colleagues reviewed charts of more than 480 patients treated in the Froedtert Hospital obesity and metabolic syndrome clinic, and found 46 obese patients who met the study criteria. Outcome data on those patients showed that after six months of treatment, their collective body mass index dropped 4.4%, their waist size dropped 4.3%, their triglycerides dropped 13.1%, and their HDL cholesterol level rose 6.2%. As a result, their 10-year risk of developing cardiovascular disease, based on scoring criteria established by the National Heart, Lung, and Blood Institute's landmark Framingham heart study was reduced by 190.5%.

The metabolic syndrome clinic team includes an endocrinologist, dietitians, a psychologist, diabetes educators, clinical pharmacist, exercise physiologists, and physical therapists. Patients had access to bariatric surgery, sleep center, and obstetrics and gynecology fertility clinic for evaluations when appropriate. They could participate in a support group, provided in collaboration with TOPS (Take Off Pounds Sensibly)."