In newly released guidelines, the Endocrine Society recommends regular screening of older adults at high risk for heart disease and type 2 diabetes.
Measuring waist circumference, checking blood pressure, HDL cholesterol levels, lipids and blood sugar levels are all small reflexes that health professionals should adopt when they receive an elderly person in their practice in order to detect earlier certain diseases.
This is what the Endocrine Society now recommends. In a clinical practice guideline published Wednesday July 31, the American medical society examines the metabolic risk of seniors in the light of the latest research, in particular that on blood pressure and blood lipids. Its last recommendations dated back to 2008.
Better detect metabolic syndrome
Rather than focusing on the risk of metabolic syndrome, the Endocrine Society lists a whole series of measures aimed at better identifying and reducing the risk of developing type 2 diabetes and atherosclerotic cardiovascular disease.
The authors of these new guidelines have identified 5 risk factors: a large amount of abdominal fat, low levels of HDL cholesterol (ie “good” cholesterol), high levels of triglycerides (fats) in blood, high blood pressure and high blood sugar.
According to them, patients with at least 3 of these factors are at risk of metabolic syndrome. Also called “syndrome X”, Metabolic syndrome is a set of metabolic dysfunctions. People who suffer from it have a greater risk of developing type 2 diabetes or atherosclerosis (loss of elasticity of the arteries). They are also at greater risk of developing atherosclerotic cardiovascular disease, in which fatty deposits build up inside the walls of the arteries and impede blood flow. This process can lead to stroke or heart attack.
Change of lifestyle
In its guide, the Endocrine Society recommends that doctors learn about the lifestyle of people at risk, as poor diet and physical inactivity increase the risk of developing metabolic syndrome. These guidelines are intended for adults between the ages of 40 and 75, but they can also be used to guide patients outside this age range.
“We emphasize the importance of lifestyle, dietary and behavioral changes as first-line treatment. However, drug therapy is appropriate if goals are not achieved through lifestyle changes alone,” says L. Rosenzweig, a physician at the Hebrew Rehabilitation Hospital in Boston and chairman of the drafting committee for these new guidelines.
The recommendations issued by the Endocrine Society are as follows:
– Measure waist circumference as part of routine clinical examinations.
– Check blood pressure once a year and, if high, at each subsequent visit.
– Prioritize lifestyle modification as first-line treatment.
– Set the goal of losing 5% or more of your initial body mass during the first year in people at metabolic risk who are overweight.
– Be the subject of a ten-year comprehensive assessment of the risks of coronary artery disease or atherosclerotic cardiovascular disease in order to guide the use of medical or pharmacological therapy.
– Prescribe lifestyle modifications before drug treatment in patients with prediabetes to reduce their blood sugar levels.
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