A huge study from Korea confirms that people with Metabolic Syndrome are at increased risk for heart attacks, and that when they correct some or all of the components of Metabolic Syndrome, their risk for a heart attack goes down dramatically (Annals of Internal Medicine, Nov 25, 2019;141(8):628-634). The researchers define “Metabolic Syndrome” as having one or more of the following:
• high blood pressure, or use of a drug to lower high blood pressure
• unhealthful cholesterol levels (LDL >100 mg/dL), or use of a drug to lower cholesterol
• high fasting blood sugar (>100 mg/dL), or the use of an antidiabetic drug
• high triglyceride level (>150 mg/dL), or use of a drug to lower triglycerides
• excess abdominal fat

The Study
The researchers used records from their National Health Insurance Database on 9,553,042 adults without heart disease, followed through three annual exams. They found that almost 30 percent (2,612,379) had metabolic syndrome, and of those:
• 1,486,485 (56 percent) had chronic metabolic syndrome before the study started,
• 587,088 (22.5 percent) developed metabolic syndrome after the study began, and
• 538,806 (21.5 percent) recovered from metabolic syndrome during the study period.

These patients were then followed for an additional 3.5 years to record incidents of:
• sudden death from a heart attack or other heart disease
• surgery to open closed heart arteries
• an acute but not fatal heart attack
• a stroke from an acute blocked artery in the brain

The researchers found that the group of patients who had recovered from metabolic syndrome had half the heart incidents compared to those who had chronic metabolic syndrome throughout the study period, and reducing high blood pressure to normal was associated with the largest difference. The people who developed metabolic syndrome during the study had significantly higher risk than the patients without metabolic syndrome, but had about three-quarters of the risk of the chronic group, probably because they did not have metabolic syndrome as long.

Metabolic Syndrome or Pre-Diabetes in North America
In North America, where about 70 percent of adults are overweight or obese, doctors use the terms “metabolic syndrome” or “pre-diabetes” to help their patients understand the risk of developing Type II diabetes that often leads to a heart attack. See The Hidden Epidemic of Early Diabetes. These people usually have a high rise in blood sugar after meals, which causes considerable cell damage and puts them at risk for all of the horrible side effects of diabetes.

If you have three or more of the following risk factors, you are probably already diabetic or pre-diabetic:
• store fat predominantly in your belly, rather than your hips
• family history of diabetes
• overweight
• exercise fewer than three times a week
• high blood pressure (systolic above 120 at bedtime)
• LDL (bad) cholesterol higher than 100 mg/dl
• HDL (good) cholesterol lower than 40 mg/dL
• triglyceride level greater than 150 mg/dL
• history of diabetes during pregnancy or birth to a baby over nine pounds
• thick neck
• polycystic ovary syndrome
• history of blood vessel disease to heart, brain, or legs
• HBA1C greater than 5.7
• fasting blood sugar greater than 100
• blood sugar one hour after eating greater than 145 mg/dL
• member of a high-risk ethnic population (e.g., African-American, Hispanic/Latino-American, American Indian, Alaskan Native or Pacific Islander)

My Recommendations
North American adults have a 40 percent chance of dying from a heart attack or a stroke, and the most common risk factors for heart attacks and strokes are being overweight or diabetic. If you are already diabetic, you may be able to cure your diabetes and prolong your life by following all the rules for an anti-inflammatory lifestyle. See Most Type II Diabetics Could Be Cured with Lifestyle Changes.

I believe that everyone should try to follow the rules for healthful living most of the time; if you don’t have any of the risk factors, try to stay that way!