Measuring Metabolic Syndrome and Success in Treating Met-S with Behavioral Interventions

Newswise — Good news! A new study being presented at ISHIB2006 shows that individuals can take charge of their health by following a prescribed set of activities designed to reduce risk factors for heart disease. Transcendental Meditation (TM) and a time-and-attention-matched health education program have been found to reduce six risk factors used to determine metabolic status.

With rates of obesity and metabolic syndrome highest among older Hispanic American and African American women,1-3 doctors and other healthcare professionals look for ways to help this population control risk factors associated with metabolic syndrome: obesity (as noted by waist circumference), glucose metabolism, blood cholesterol and triglyceride levels, and blood pressure.

In two studies presented today at ISHIB2006, Kenneth G. Walton, PhD, Carolyn Gaylord-King, PhD, and colleagues first developed a measuring stick for metabolic syndrome and then used the measure to determine benefits of behavioral techniques to reduce metabolic syndrome in a high-risk population. Termed the composite syndrome index, the measure is a way of combining information into a single number that is highly correlated with each of the six risk factor components of the syndrome: waist circumference, and the levels of triglycerides, HDL-C (high-density lipoprotein cholesterol), fasting glucose, and systolic and diastolic blood pressures.

The method of calculating the index was based on the study of Pladevall and colleagues indicating the existence of a single latent factor underlying the metabolic syndrome.4 Dr. Walton states: "This composite syndrome index was developed as a research tool for comparing different interventions and different subgroups of patients. Additional research is needed to determine its potential usefulness in the treatment of individual patients."

To develop the correlation between the risk factors and the composite index, the researchers studied 200 inner-city African American women at high-risk for cardiovascular disease. Of the 200 participants, 128 were obese and 98 (49%) met the criteria for metabolic syndrome as set by National Cholesterol Education Program " Adult Treatment Panel III (NCEP ATP III) standard criteria.

In the second part of their study, Walton et al examined the effects of two behavioral interventions on the composite index of metabolic syndrome. Participants were 81 African American women from the first part of the study and who had metabolic syndrome with uncontrolled blood pressure despite medications. Patients were randomly assigned to a group receiving Transcendental Meditation (TM) instruction and a group receiving a time-and-attention-matched health education program. Measurements on the six risk factors described above were taken before and after one year of these programs.

The TM program has been found to decrease cardiovascular risk factors in African Americans.5,6 It is a natural mental technique practiced 20 minutes twice a day with the participant sitting comfortably with eyes closed. During the TM technique, thinking processes become less active and a state of "restful alertness" appears to be gained that frees the mind/body of stressful experiences.7 For those in group 2, the health education components included detailed information on the risk factors for heart disease and stroke, elaborate training on appropriate exercises, and extensive instructions on selecting and preparing healthy foods.

Both groups experienced lower rates for many of the individual risk factors of metabolic syndrome. For those receiving health education, declines were seen in systolic and diastolic blood pressure, triglyceride levels, and fasting glucose levels. TM group participants had declines in systolic and diastolic blood pressure, triglyceride levels, fasting glucose levels, waist circumference, and an increase in the "good" cholesterol (HDL-C). See Table attached.

In previous studies, carotid intima-media thickness (IMT) has been found to be a predictor of heart disease including stroke and other coronary outcomes.8 For the current study, the scientists also measured carotid IMT in both study groups and found that, during the study period, IMT did not change significantly for participants in either group " a contrast to the usual increase observed in such high-risk populations over a one-year period.

These scientific findings were presented today at the 21st International Interdisciplinary Conference on Hypertension and Related Cardiovascular Risk Factors in Ethnic Populations as Abstracts 033 and 034. Both abstracts are attached to this release.

Additional conference information and news from the conference can be found at http://www.ishib.org/ISHIB2006.

ISHIB2006 is jointly sponsored by ISHIB and the American Society of Hypertension (ASH). ISHIB (The International Society on Hypertension in Blacks) is a nonprofit, professional medical membership organization devoted to improving the health and life expectancy of ethnic populations. ISHIB was founded in Atlanta, Georgia, in 1986 to respond to the problem of high blood pressure among ethnic populations. Each year, its international interdisciplinary conference presents advancements in the treatment and prevention of cardiovascular diseases tp reduce the health disparities among ethnic minority populations. In addition to US conference locations, other sites for the conference have included Toronto, London, the US Virgin Island, Kenya, Cameroon, and Brazil.

References

1. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults. Findings from the Third National Health and Nutrition Examinatioin Survey. JAMA. 2002; 287:356-359.2. Hall WD, Clark LT, Wenger NK et al. The metabolic syndrome in African Americans: a review. Ethn Dis. 2003; 13:414-428.3. Smith SC, Jr., Clark LT, Cooper RS et al. Discovering the full spectrum of cardiovascular disease: Minority Health Summit 2003: Report of the Obesity, Metabolic Syndrome, and Hypertension Writing Group. Circulation. 2005: 111:e134-e139.4. Pladevall M, Singal B, Williams LK et al. A single factor underlies the metabolic syndrome. A confirmatory factor analysis. Diabetes Care. 2006; 29:113-1225. Schneider RH, Staggers F, Alexander C, et al. A randomized controlled trial of stress reduction for hypertension in older African Americans. Hypertension. 1995;26:820-827.6. Alexander CN, Schneider R, Claybourne M, et al. A trial of stress reduction for hypertension in older African Americans, II: sex and risk factor subgroup analysis. Hypertension. 1996;28:228-237.7. Jevning R, Wallace RK, Biedebach M. The physiology of meditation: a review: a wakeful hypometabolic integrated rsponse. Neurosci Biobehav Rev. 1992; 16:415-424.8. O'Leary DH, Polak JF, Kronmal RA et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults: Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999;340:14-22.