The American Heart Association estimates that 50 million Americans have metabolic syndrome—a constellation of conditions that increase heart disease risk and tend to occur together. These conditions include excess abdominal fat, high blood pressure, low HDL (good) cholesterol, high triglycerides, and insulin resistance, as well as a tendency toward inflammation and blood clots. Metabolic syndrome raises the risk for heart attack , stroke , and type 2 diabetes .

Some research has hinted that metabolic syndrome—and insulin resistance, in particular—are also associated with heart failure. Due to dysfunction in the heart’s blood-pumping ability, heart failure may cause shortness of breath, leg swelling, chronic cough, and weight gain. It is theorized that insulin resistance, the body’s inability to use insulin effectively, may directly impair heart function due to high insulin levels in the bloodstream. Researchers are investigating the role of metabolic syndrome as a predictor for heart failure.

In a study that tracked the health of Swedish men from age 50-70, the men with metabolic syndrome were significantly more likely to develop heart failure than those without the syndrome. This report is published in the May 22, 2006 online version of Heart .

About the Study

In the early 1970s, researchers from Uppsala University in Sweden recruited 2,314 fifty-year-old men. Each man underwent a physical exam, which included measurement of blood pressure; body mass index (BMI); and levels of cholesterol, insulin, and triglycerides. For the next 20 years, the researchers re-examined the men regularly, looking for signs of heart failure. The men who developed heart failure over the course of the study were compared with those who did not.

Men with metabolic syndrome at the start of the study were significantly more likely to develop heart failure over the next 20 years than men without this syndrome. This connection remained strong even after researchers separated out the influence of smoking, dysfunctional heart valves, and other factors known to raise the risk for heart failure.

Since this study examined Swedish men aged 50-70, it is unclear if metabolic syndrome will have the same connection with heart failure in women or people of other ages and ethnicities.

How Does This Affect You?

This study contains some bad news and some good news. The bad news is that the health consequences of metabolic syndrome are mounting—heart failure can be added to the list along with type 2 diabetes, heart attack, and stroke.

The good news is that the individual components of metabolic syndrome can be modified through lifestyle changes and/or medications. While it may seem overwhelming to try to manage a whole cluster of conditions, the following healthful habits target several of the conditions at once:

  • Achieve a desirable weight (BMI <25; or waist circumference <40 inches for men or <35 inches for women) through dietary changes and exercise
  • Strive for at least 30 minutes of moderate intensity activity on most days of the week; check with your doctor before beginning an exercise program
  • Eat more fruits, vegetables, whole grains, and lean sources of protein
  • Choose a diet as low in trans and saturated fat as possible; use unsaturated fats instead
  • If you smoke, quit

In addition, talk with your doctor about the need for medication to help manage diabetes, high blood pressure, and elevated blood fats (cholesterol and triglycerides).