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Metabolic Syndrome Patient Compliance

Date: February 14, 2011
Source: Admin

Patients with metabolic syndrome need to be evaluated for compliance with drug treatment to determine association between access to and use of medicines, as well as the level of knowledge of cardiovascular risk factors and compliance. Metabolic syndrome includes a group of conditions that, when occurring together, place a person at a high risk of developing type 2 diabetes and cardiovascular diseases, including heart attack and stroke.

Metabolic syndrome is defined as the presence of any three of the following five conditions

Waist measurement of 40 inches or more for men and 35 inches or more for women
Triglyceride levels of 150 milligrams per deciliter (mg/dL) or above, or taking medication for elevated triglyceride levels
HDL (“good”) cholesterol levels below 40 mg/dL for men and below 50 mg/dL for women, or taking medication for low HDL levels
Blood pressure levels of 130/85 or above, or taking medication for elevated blood pressure levels
Fasting blood glucose levels of 100 mg/dL or above, or taking medication for elevated blood glucose levels

Successful treatment faces a huge challenge with low compliance.

Risk factors for the development of metabolic syndrome

Obesity or being overweight or obese
Leading a sedentary lifestyle
Smoking
Eating a high fat or processed carbohydrates diet

Diagnosis of Metabolic Syndrome

Full medical evaluation

· Compiling and analyzing many factors that impact the risk of developing metabolic syndrome and its complications

· Blood tests

· EKG

· Imaging tests

Medical History and Physical Examination

· Assessment of weight

· Waist measurement

· Series of blood pressure readings

Diagnostic Testing

Blood Tests

Cholesterol Testing

· to measure cholesterol levels

· total amount of cholesterol

· three components of cholesterol

HDL

LDL

triglycerides

· Random blood glucose test or an urinanalysis

to measure high levels of glucose

· Fasting blood glucose test

to detect hyperglycemia

· Glycated hemoglobin (A1C) test

to measure the average overall blood sugar for the past several months

Compliance with Drug Treatment

To evaluate compliance with drug treatment, compliance is set as the dependent variable. Independent variables include access to medicines, the use of medicines and the level of knowledge concerning cardiovascular risk factors.

Diet

· Mediterranean diet rich in "good" fats (olive oil) and contains a reasonable amount of carbohydrates and proteins (such as from fish and chicken)

· Less saturated fat

· Fewer calories

· Reduction of alcohol consumption

Noncompliance leads to drug treatment

Exercise

There is a beneficial effect of exercise on blood pressure, cholesterol levels, and insulin sensitivity, regardless of whether weight loss is achieved or not.

Noncompliance leads to drug treatment

Cosmetic surgery to remove fat

Data thus far shows no benefit in liposuction on insulin sensitivity, blood pressure, or cholesterol.

Drugs

High blood pressure medicines

· ACE inhibitors (like Capoten and Vasotec)

· Angiotensin II receptor blockers (like Cozaar and Diovan)

· Diuretics

· Beta-blockers

· Other drug

Evaluate compliance with prescribed drugs with medical opinion

Patient compliance varies