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Metabolic syndrome – lifestyle advice WORKSHOP i Adam Windak, M.D., Ph.D

Metabolic syndrome – lifestyle advice WORKSHOP i Adam Windak, M.D., Ph.D Tomasz Tomasik, M.D., Ph.D . Department of Family Medicine Jagiellonian University Medical College. A 68-year old woman attends your practice.

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Metabolic syndrome – lifestyle advice WORKSHOP i Adam Windak, M.D., Ph.D

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  1. Metabolicsyndrome – lifestyleadvice WORKSHOP i Adam Windak, M.D., Ph.D Tomasz Tomasik, M.D., Ph.D. Department of FamilyMedicine JagiellonianUniversityMedical College

  2. A 68-year old woman attends your practice • She complains that she has been feeling weak for the last few days, asks for a BP reading and the OGTT assessment which you ordered during her last consultation • History: • Hypertension for 5 years (enarenal, indapamide) • Has been smoking half a pack of cigarettes a day for 40 years • No alcohol consumption • No family history of CVD • Physical examination: • WC 89cm • BP 135/82 mmHg • Height: 157 cm; weight 82 kg • Additional examinations: • Lipid profile normal • Chest X-ray, ECG: no abnormality • OGTT: • Fasting glucose: 5.8 mmol/l (105 mg/dl) • Glycaemia after 120 min: 7.6 mmol/l (136 mg/dl)

  3. Individual exercise • Make SOAP notes and assess the patient’s CVD risk • Use: • ESH-ESC chart to stratify CV risk • BMI chart

  4. Plenary discussion • The patient’s problems and CVD risk

  5. Fasting plasma glucose 5,6 – 6.9 mmol/l 100-125 mg/dl OGTT ≥11,1 mmol/l ≥200 mg/dl DM 7,8-11,0 mmol/l 140-199 mg/dl IGT <7,8 mmol/l <140 mg/dl IFG Oral glucose tolerance test

  6. Definition and classification of blood pressure levels (ESH-ESC)

  7. Weight classification • underweight: BMI less than 18.5 • normal weight: BMI 18.5 to 24.9 • overweight: BMI 25 to 29.9 • obese: BMI 30 and over

  8. Clinical identification of MS

  9. Exercise in 3 groups • Prepare a program for: • Nutrition • Physical activity • Smoking cessation

  10. Presentation of the programs and discussion

  11. Copy for traineeBody mass Index BMI Chart for Adults

  12. Stratification of CVD Risk (2007 Guidelines for the management of arterial hypertension, ESH and ESC) BP: blood pressure; CVD: cardiovascular; HT: hypertension. Low, moderate, high, very high risk refer to 10year risk of a CVD fatal or non-fatal event. The term “added” indicates that in all categories risk is greater than average. OD: subclinical organ damage; MS: metabolic syndrome.

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