With soaring rates of cardiovascular disease and type 2 diabetes, there is a need to inform the public how these diseases can be prevented.
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Dr. Jean-Pierre Despres: It is very important to emphasize that cardiometabolic risk is not a new term invented to replace metabolic syndrome or to replace the – that we find among patients with insulin resistance. Cardiometabolic risk emphasizes the notion that in order to appropriately assess the global cardiovascular disease risk of a given patient, we need to pay attention to the risk associated with classical risk factors such as age, smoking, LDL cholesterol, hypertension so we pay attention to the classical risk factor when present. But if the patient is abdominally obese, it is very likely to be characterized by your further increased risk of cardiovascular disease and type 2 diabetes. So really, global cardiometabolic risk is a notion to really emphasize the need to capture the risk, not only associated with the features of the metabolic syndrome but also the risk resulting from the presence of traditional risk factors. Dr. Peter Libby: I think that the coming epidemic of obesity, diabetes, metabolic syndrome is going to make a shift in the incidence cardiovascular disease going forward unless we’re able to make major in roads into stemming this coming epidemic. We’ve congratulated ourselves on decreasing age adjusted cardiovascular events over the last several decades. But unfortunately, with the aging of the population on one end and this burdening of obesity in our youngest segment of our population that we’re setting the stage for a reversal in the beneficial trends and I think that we should sound a clarion call for trying to stem this epidemic in order to prevent an increase in cardiovascular disease in the future. Dr. Robert Ross: As the waist circumference at the BMI—the information that BMI gives us in the clinical practice, I think it absolutely does. There is no question that when we use waist circumference either within the BMI categories or by itself, it’s an independent predictor of both morbidity and mortality. And I think that that’s good news for the clinician because it offers him two opportunities to determine risk in clinical practice either by waist or BMI. If had one to choose, I would select waist circumference. It’s a simple measure and absolutely an independent predictor of the morbidity and mortality that we fear and those associated with obesity. So today’s clinician is well advised to acquire waist circumference simply because for both men women independent of age, independent of race is an independent predictor of morbidity and mortality. Dr. Philip J. Barter: The debate about the metabolic syndrome is going on. It is non productive. Essentially, it is different people trying to claim ownership of the disease. I understand why people are doing this but it’s not very helpful. What we do know is that there is a condition whether we call it the metabolic syndrome or anything else that describes the cluster of associated factors that lead to increased cardiovascular risk all of which are associated with increase of this related possibility and the features of very, very well known. The only argument is whether we need to have a name.