Stroke

Syndrome X: A High Risk for Stroke?

What did it signify about the relationship between metabolic syndrome and stroke risk?
Basically we found that metabolic syndrome is an important and significant stroke risk factor overall. People are 1.6 times more likely to have a stroke if they have metabolic syndrome than if they don't. And women are at particular risk. Women with metabolic syndrome are 2.2 times more likely to have a stroke than women without metabolic syndrome.

Why is the stroke risk greater in women with metabolic syndrome than in men with the syndrome?
We don't really know. It may be that there are different physiological mechanisms going on among women than among men.

I can tell you that when you look at men and women, that there's not that much difference in terms of the prevalence of risk factors—like the prevalence of diabetes, the prevalence of high triglycerides. So it's not just that women have more of these factors. I suspect that there may be other things going on physiologically that are different between men and women.

Are people who have this syndrome aware that they have it?
I think very few people are aware of it. And I think it's important that primary care physicians be aware that patients are at increased risk of heart attack and stroke when they have this syndrome. They need to encourage people to control each of the risk factors.

What is the purpose of grouping these known risk factors together into a syndrome?
It's controversial, There are scientists and physicians who think we should just be treating each of these risk factors separately and that we gain nothing by giving it a name.

The question remains, however—when you start adding these risk factors together, does something particular change in the body that compounds the effect of these individual risk factors? That's what we really need to investigate further.

Is it possible to treat this syndrome?
The good news is that most of these risk factors, if not all of them, are modifiable. We can decrease weight and increase our physical activity, which will increase our good cholesterol and address the weight risk factor. We can decrease our blood pressure through medication, through diet and through exercise again. The same with diabetes and triglycerides—there are some agents that are supposed to reduce LDL, the bad cholesterol, and they may work in reducing triglycerides.

What advice would you give people who may have these risk factors?
The first thing is to talk to your doctor about it. What is metabolic syndrome? Do I have this? I think I'm a little bit overweight. I think my blood pressure is high and my cholesterol is high, and I've heard this is serious so can I do something about it?

Reducing risk of stroke and cardiovascular disease is both a mission on the part of the patient as well as the physician. Maybe if we talk about the metabolic syndrome, we can create a dialogue between patient and physician and we can really start to work on behavior change and modification.

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