Drugs Are Not Enough: The Metabolic Syndrome—A Call for Intensive Therapeutic Lifestyle Change
Article first published online: 21 JAN 2009
© 2009 Wiley Periodicals, Inc.
Journal of the CardioMetabolic Syndrome
Volume 4, Issue 1, pages 20–25, Winter 2009
How to Cite
Brown, T. M., Sanderson, B. K. and Bittner, V. (2009), Drugs Are Not Enough: The Metabolic Syndrome—A Call for Intensive Therapeutic Lifestyle Change. Journal of the CardioMetabolic Syndrome, 4: 20–25. doi: 10.1111/j.1559-4572.2008.00031.x
- Issue published online: 20 FEB 2009
- Article first published online: 21 JAN 2009
- Manuscript received November 14, 2007; revised April 3, 2008; accepted April 11, 2008
Whether intensive pharmacologic cardiovascular risk factor management reduces metabolic syndrome (MetS) prevalence is unknown. The authors compared the number of secondary prevention medications and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)–defined MetS prevalence in coronary artery disease patients entering cardiac rehabilitation from 1996 to 2001 (period 1, n=516) with those entering from 2002 to 2006 (period 2, n=609). Age, sex, and ethnicity were similar in both periods. From period 1 to period 2, participants took more secondary prevention medications (2.8±1.3 vs 3.5±1.0, P<.001). Prevalence of low high-density lipoprotein cholesterol (66% vs 66%), diabetes (37% vs 38%), and hypertension (81% vs 81%) were unchanged. The prevalence of hypertriglyceridemia decreased (48% vs 36%, P<.001), but the proportion meeting criteria for elevated waist circumference increased (51% vs 58%, P<.05), resulting in no change in overall MetS prevalence (60% vs 59%, P=NS). More emphasis on therapeutic lifestyle change in addition to intensive pharmacologic therapy is needed to reduce MetS prevalence in patients with coronary artery disease.