Cardiometabolic syndrome (CMS), also known as metabolic syndrome, is a cluster of metabolic disorders that significantly increase a person’s risk of cardiovascular diseases and type 2 diabetes. CMS is a combination of conditions such as insulin resistance, impaired glucose tolerance, dyslipidemia (abnormal cholesterol levels), hypertension (high blood pressure), and central adiposity (excess fat around the waist).

CMS is unfolding as a new topic of cardiology research because it highlights the intricate and essential relationships among obesity, insulin resistance, and cardiovascular well-being. Understanding CMS and its causes, as well as exploring new ways to diagnose and treat it, is essential for a brighter public health future. Advancements in our knowledge of CMS empower the cardiology field to evolve into a holistic, individualized cardiovascular care domain.

Prevalence

The global rate of CMS continues to rise. Currently, about 1 in 3 adults have metabolic syndrome. The National Health and Nutrition Examination Survey (NHANES) found that in 2007–2014, 35.3% of men and 33.3% of women had CMS. In the United States, the prevalence of CMS increases with age and is higher in Black women (40%) than in Black men, White women, or White men.

 

Key Comp0nents

The main components of CMS include:

• Insulin Resistance        
  A condition where the body’s cells do not respond effectively to insulin, which increases a person’s blood glucose level. Insulin resistance can make the liver produce more of the bad cholesterol and fats that lead to increased serum triglycerides and LDL levels. Insulin resistance also leads to microvascular damage and endothelial dysfunction, both of which increase the risk of developing hypertension and atherosclerosis (hardening of the arteries).
• Impaired Glucose Tolerance
  Higher-than-normal blood sugar levels that do not yet qualify as diabetes.
• Dyslipidemia
  Abnormal levels of lipids in the blood, including high levels of triglycerides and LDL (“bad”) cholesterol and low levels of HDL (“good”) cholesterol.
• Hypertension
  Persistently high blood pressure.
• Central Adiposity
  Excess fat accumulation around the abdomen,  often measured by waist circumference.

 

Risk Factors

Several risk factors contribute to the development of CMS, including:

• Genetic Predisposition
• Family History of Diabetes, Cardiovascular Diseases, or Metabolic Disorders
• Dyslipidemia
  In CMS, dyslipidemia is a combination of high triglycerides, LDL (“bad” cholesterol), and low HDL-C levels.
• Lack of Sleep
  Can lead to problems with how the body absorbs nutrients from food.
• Occupation
  Certain jobs can put a person at higher risk of CMS. For example, shift workers often have misaligned circadian clocks, which also affect metabolism and how the body absorbs nutrients.

 

 

Lifestyle Factors in Cardiometabolic Syndrome

Poor diet, physical inactivity, smoking, and excessive alcohol consumption are the main lifestyle drivers of cardiometabolic syndrome.

• Obesity and Overweight
  Overweight and obesity—especially central obesity—are common in people with CMS. Central obesity is believed to contribute to the pro-inflammatory state that is part of CMS. Overeating leads to changes in fat cells that cause inflammation and central obesity. It also increases blood glucose levels and insulin resistance.
• Age and Ethnicity
  Older age and certain ethnic backgrounds (such as African American and Mexican American) are associated with a higher risk of CMS.
• Hormonal Imbalances
  Conditions like polycystic ovary syndrome (PCOS) and menopause can also contribute.

 

Health Consequences of Cardiometabolic Syndrome

Individuals with CMS are at significantly increased risk for:

• Cardiovascular Diseases
  Including heart attacks, strokes, and atherosclerosis (hardening of the arteries)
• Type 2 Diabetes
  Due to impaired glucose tolerance and insulin resistance
• Kidney Disease
  Chronic kidney disease (CKD) can result from the same risk factors that contribute to cardiometabolic syndrome.
• Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)
  Also called non-alcoholic fatty liver disease (NAFLD), this is an accumulation of fat in the liver that is unrelated to alcohol consumption. It often co-occurs with other metabolic disorders such as high cholesterol, obesity, and diabetes.

 

Prevention and Management

Preventing and managing cardiometabolic syndrome involves a combination of lifestyle changes and medical treatments:

Lifestyle Modifications

• Diet
  Adopting a heart-healthy diet rich in whole grains, fruits, vegetables, and fish
• Exercise
  Regular physical activity to maintain a healthy weight and improve metabolic health
• Weight Management
  Achieving and maintaining a healthy body weight
• Smoking Cessation
  Quitting smoking to reduce cardiovascular risk
• Reducing Alcohol Intake
  Limiting alcohol consumption to moderate levels

Medical Treatments

• Medications
  To control blood pressure, cholesterol levels, and blood sugar
• Regular Monitoring
  Frequent health check-ups to monitor and manage risk factors effectively

 

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