Impact of Metabolic Syndrome Screening and Education on

Cardiovascular Disease Risk Magnitude

Herlina and Julaeha

Magister Pharmacy, Faculty of Pharmacy, 17 Agustus 1945 University, Jakarta, Indonesia

Keywords: Metabolic Syndrome, Cardiovascular Disease, Healthy Lifestyle, Preventive Efforts.

Abstract: Background: Metabolic syndrome is one of the triggers of cardiovascular disease, the leading cause of death

worldwide, caused by blockages and abnormalities in the heart. The aim of this study was to determine the

impact of metabolic syndrome screening and education on the risk of cardiovascular disease. Methods: The

research method used was a systematic review conducted by searching for articles related to the relationship

between metabolic syndrome and cardiovascular disease risk that have been published. Results: A systematic

review of published journals showed that there is a significant association indicating that a person with

metabolic syndrome is likely to be at risk of cardiovascular disease. Results: Based on the journals that were

combined and synthesised, there is an association between metabolic syndrome and lifestyle with

cardiovascular disease. Metabolic syndrome screening and education, as well as healthy lifestyle changes, are

needed to prevent and reduce the risk of cardiovascular disease. Conclusion: Early screening to detect

metabolic syndrome and education related to healthy lifestyle and preventive efforts need to be done to prevent

complications of metabolic syndrome to the risk of cardiovascular disease.

INTRODUCTION

Metabolic syndrome is often defined as a complex

metabolic disorder involving abnormalities in the

metabolism of macromolecules such as

carbohydrates, lipids and proteins. Components The

main components of metabolic syndrome are obesity,

insulin resistance, dyslipidaemia and hypertension

(Guembe et al, 2020). Syndrome Metabolic syndrome

is a collection of metabolic risk factors that are

directly related to the occurrence of cardiovascular

disease. These risk factors include atherogenic

dyslipidaemia, elevated blood pressure, elevated

plasma glucose levels, prothrombin state and

proinflammatory state (Salari et al., 2020).

Prevalence of metabolic syndrome based on an

epidemiological survey. The International Diabetes

Federation puts the figure at 20-25%. The prevalence

of metabolic syndrome in the adult population is

reported to be around 15% in Europe, 14.2% in South

Korea and 24% in the Americas. In Indonesia,

23.34% of the total population has metabolic

syndrome, of which 26.6% are men and 21.4% are

women (Ntougou Assoumou et al., 2023).

Metabolic syndrome is a cluster of metabolic risk

factors directly linked to the development of

atherosclerotic cardiovascular disease. Although

metabolic syndrome is not a disease but a collection

of symptoms, early detection in an individual will be

of great importance if it is to be resolved and treated

immediately. This is because the collection of clinical

symptoms that occur together contribute to

cardiovascular disease (Ananthy et al, 2021).

It is estimated that in the next five to ten years, the

risk of type 2 diabetes mellitus (DM) will increase

fivefold and the risk of cardiovascular disease will

increase twofold. Cardiovascular disease will double.

Patients with metabolic syndrome have two to four

times the risk of stroke and three to four times the risk

of heart attack. Other studies have also suggested a

positive relationship between knowledge, attitudes

and behaviours about healthy lifestyles and several

cardiovascular disease risk factors, such as fasting

blood glucose, waist circumference and body mass

index and blood pressure. This means that the higher

or better the level of knowledge, attitudes and

behaviours related to healthy lifestyles, the higher the

risk factors (Gebreegziabiher et al., 2021).

Herlina, . and Julaeha, .

Impact of Metabolic Syndrome Screening and Education on Cardiovascular Disease Risk Magnitude.

DOI: 10.5220/0012585000003821

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 4th International Seminar and Call for Paper (ISCP UTA ’45 JAKARTA 2023), pages 161-164

ISBN: 978-989-758-691-0; ISSN: 2828-853X

161

METHODS

The research method used was a systematic review,

which was conducted by searching for published

articles on the relationship between metabolic

syndrome and cardiovascular disease risk. The source

of data for this study came from literature obtained

through the internet, in the form of research results

published in Google Scholar during the period 2019-

2023.

RESULTS AND DISCUSSION

3.1 Metabolic Syndrome

Metabolic syndrome is a group of health conditions

that occur together. It can increase the risk of

coronary heart disease, heart attack, type 2 diabetes

and stroke. A person is said to have metabolic

syndrome if they have at least three of the following

five conditions: high blood pressure (hypertension),

low HDL levels (dyslipidaemia), high triglyceride

levels, high blood sugar levels or pre-diabetes, and

obesity with abdominal fat accumulation. Metabolic

syndrome can increase the risk of developing serious

diseases. However, the development of metabolic

syndrome can be prevented by controlling the factors

that lead to these five conditions, namely by adopting

a healthy lifestyle every day (Iso et al, 2021).

Metabolic syndrome is a metabolic disorder

mainly caused by obesity and insulin resistance (Li et

al., 2020). The components of metabolic syndrome

are central obesity, blood glucose levels, triglyceride

levels, HDL cholesterol levels and blood pressure.

HDL cholesterol and blood pressure. Central obesity

is considered to be the main cause of metabolic

syndrome, which is characterised by an abdominal

circumference greater than normal, i.e. more than 80

cm for women and more than 90 cm for men. The

prevalence of metabolic syndrome in Indonesia is still

quite high at 21.66%. People with metabolic

syndrome have a higher risk of developing

cardiovascular complications such as stroke and

coronary heart disease. A sedentary lifestyle with

poor diet and low levels of physical activity leads to

a high incidence of metabolic syndrome

(Zolghadrpour et al, 2023).

3.2 Cardiovascular Disease

Cardiovascular disease is caused by disorders of the

heart and blood vessels. Heart disease and stroke are

the two most common cardiovascular diseases. In

addition, there are other cardiovascular diseases that

are common and worthy of attention. In Indonesia,

cardiovascular diseases cause about 651,481 deaths

every year. Unhealthy lifestyles such as eating too

much fatty food, not exercising regularly, smoking

and excessive alcohol consumption are some of the

risk factors for cardiovascular disease (Chae et al., 20-

23).

The cardiovascular system is responsible for

circulating blood throughout the body. If there is a

disorder or blockage in this part of the body, blood

circulation is disturbed and this can lead to various

cardiovascular diseases. The following are the most

common cardiovascular diseases that you need to be

aware of:

3.2.1 Arrhythmia

Arrhythmia is a condition in which the heart has an

abnormal beat or rhythm, such as too fast, too slow or

irregular. This cardiovascular disease occurs when

the electrical impulses that control the heartbeat do

not work properly.

3.2.2 Coronary Heart Disease (CHD)

Coronary heart disease (CHD) is a blockage or

narrowing of the coronary arteries caused by plaque

build-up. This condition reduces the blood supply to

the heart. If left untreated, this cardiovascular disease

can lead to heart attack, irregular heartbeat and heart

failure.

3.2.3 Stroke

A stroke occurs when the blood supply to the brain is

interrupted by a blocked or ruptured blood vessel.

Without sufficient blood supply, the brain is deprived

of oxygen and nutrients. As a result, the cells in the

brain are damaged, causing cardiovascular disease in

the form of a stroke.

3.2.4 Cardiomyopathy

Cardiomyopathy is a cardiovascular disease caused

by abnormalities in the heart muscle. It is

characterised by a weakening of the heart's ability to

pump blood. Cardiomyopathy can lead to serious

complications such as heart valve disease, blood

clots, heart failure and cardiac arrest.

3.2.5 Deep Vein Thrombosis (DVT)

Deep vein thrombosis is a cardiovascular condition

ISCP UTA ’45 JAKARTA 2023 - THE INTERNATIONAL SEMINAR AND CALL FOR PAPER (ISCP) UTA ’45 JAKARTA

162

caused by blood clots in the veins. It usually occurs in

the legs. In some cases, the blood clot can travel with

the bloodstream to the lungs and cause serious

complications, such as a pulmonary embolism.

3.2.6 Peripheral Arterial Disease

Peripheral arterial disease (PAD) occurs when blood

flow to the legs is blocked due to plaque build-up in

the arteries. This cardiovascular disease can deprive

the legs of blood supply, causing pain when walking.

3.3 Result

In a study conducted by Sudijanto Kamso (2011), the

prevalence and determinants of metabolic syndrome

in the executive group in Jakarta and surrounding

areas were determined by conducting multiple

logistic regression analysis to determine the

relationship between several independent variables

and the dependent variable. This analysis identified

body mass index (overweight, odds ratio (OR) = 5.54;

obesity, OR = 7.44) and total cholesterol/HDL

cholesterol (HDL) ratio (OR = 8.83) as determinants

of metabolic syndrome in the executive group. This

study suggests that regular lipid profile screening and

simple anthropometric measurements in the

managerial group are important to detect the risk of

metabolic syndrome.

(Zheng et al, 2023) in his study Impact of

Metabolic Syndrome on the Development of

Cardiovascular Disease in a General Japanese

Population The Hisayama Study. He found that the

overall prevalence of MetS at baseline was 25.9%.

Baseline characteristics based on sex and MetS are

shown in Table 1. The prevalence of MetS at baseline

was 21% in men and 30% in women. There were 307

CVD events during follow-up. Compared with those

without MetS, the age-adjusted incidence of CVD

(per 1000 person-years) was significantly higher in

subjects with MetS in both men (21.8 versus 11.6,

P0.01) and women (12.9 versus 6.5, P0.01). The risk

of CVD events was significantly higher even after

adjustment for the following confounders: age,

proteinuria, electrocardiographic abnormalities,

serum total cholesterol, smoking habits, alcohol

intake and regular exercise (hazard ratio, 1.86; 95%

CI, 1.32 to 2.62 in men and hazard ratio, 1.70; 95%

CI, 1.22 to 2.36 in women). The risk of incident CVD

was found to increase with the number of components

of the MetS and became significantly predictive when

the number of components reached 3. Similar

associations were also observed when CVD was

divided into coronary heart disease and stroke.

The impact of lifestyle modification education on

cardiovascular risk profile was studied by Fonny

Cokro. She found that Comparison analysis of

knowledge before and after education Data analysis

using Wilcoxon signed rank test showed that there

was a significant increase in knowledge between

before and after education on face-to-face sessions

group (p0.05). Comparative analysis of participants'

dietary behaviour (based on HDI) before and after the

training Data analysis using the Wilcoxon signed test

showed that there was no significant change in HDI

in all groups (p>0.05) between before and after the

training. Comparison analysis of BMI and waist

circumference before and after training Data analysis

using the Wilcoxon signed test showed that there was

no significant reduction in BMI and waist

circumference in all groups (p>0.05) between before

and after training. Comparative analysis of

cardiovascular risk profile before and after education

Data analysis using Wilcoxon signed test showed that

there was no significant reduction in cardiovascular

risk profile in all groups (p>0.05) between before and

after education intervention.

Lifestyle modification education can significantly

increase patients' knowledge in the face-to-face

group, but not in the recorder and combination

groups. Lifestyle modification education had no

significant effect on dietary behaviour based on HDI,

BMI, waist circumference and cardiovascular risk

profile in all groups. A long-term intervention and a

multi-component programme including behavioural

therapy may be needed to improve lifestyle changes

and reduce cardiovascular risk (Lee & Park, 2023).

Tri Umiana Soleha and M. Azzaky Bimandama

said that the prevalence of MS has reached a fantastic

number, which is 20-25% in the world. In patients

with MS, metabolic changes are seen in the body, so

if the patient has SM, they are very vulnerable to

developing cardiovascular disease. This vulnerability

increases the risk of death in both women and men.

Conclusion Metabolic syndrome (MS) has a very

close relationship with cardiovascular disease. Using

the pathophysiology and criteria of MS, various

syndromes will present as a disease and complicate

into cardiovascular disease.

The NAZARENE FILADELFIA CHRISTIAN

CHURCH YOGYAKARTA study found that the

provision of MS-related education did not cause

changes in glucose tolerance test, uric acid and

systolic blood pressure levels. The provision of

education may cause significant changes in diastolic

blood pressure of 6.3 mmHg, but not clinically, as

systolic blood pressure before and after education is

still within normal limits. Examination of total

Impact of Metabolic Syndrome Screening and Education on Cardiovascular Disease Risk Magnitude

163

cholesterol results showed a mean of 162.3 mg/dl

before education, and the mean total cholesterol

increased significantly after education (196.7 mg/dl),

although it is still within the tolerance limit of less

than 200 mg/dl.

And the metabolic syndrome, as defined by the

NCEP criteria, was less common in people with a

university education (21% in men and 14% in

women) than in those with a primary education (41%

and 27%, respectively). Adjustment for health

behaviours had little effect on the educational

gradient in metabolic syndrome. There was a clear

educational gradient in CHD incidence [hazard ratio

(HR) = 0.67 95% confidence interval (CI) 0.48-0.94,

men and women combined]. Adjustment for

metabolic syndrome attenuated this gradient only

slightly, but when individual components of

metabolic syndrome were included as covariates, the

attenuation was more substantial (HR = 0.73 95% CI

0.52-1.04).

CONCLUSIONS

Based on the journals analysed, combined and

synthesised, there is an association between

metabolic syndrome and lifestyle with cardiovascular

disease. Screening and education about metabolic

syndrome is needed so that people understand how

dangerous metabolic syndrome is in increasing the

risk of cardiovascular disease. Healthy lifestyle

changes are also needed to prevent and reduce the risk

of cardiovascular disease. Lipid profile/blood lipid

levels should be measured to detect metabolic

syndrome.

REFERENCES

Ananthy, V., Priyadharsini, R. P., & Subramanian, U. (2021).

Pathogenesis, Diagnosis, and Management of Metabolic

Syndrome: A Comprehensive Review. SBV Journal of

Basic, Clinical and Applied Health Science, 4(2), 39–45.

https://doi.org/10.5005/jp-journals-10082-03111

Chae, W., Lee, H. S., Jo, J. H., Chung, M. J., Bang, S., Park,

S. W., Song, S. Y., Jang, S. I., & Park, J. Y. (2023).

Impact of cholecystectomy on acute coronary syndrome

according to metabolic condition: a nationwide

population-based cohort study. Scientific Reports, 13(1),

1–8. https://doi.org/10.1038/s41598-023-33440-4

Gebreegziabiher, G., Belachew, T., Mehari, K., & Tamiru, D.

(2021). Magnitude and associated factors of metabolic

syndrome among adult urban dwellers of Northern

Ethiopia. Diabetes, Metabolic Syndrome and Obesity,

14, 589–600. https://doi.org/10.2147/DMSO.S287281

Guembe, M. J., Fernandez-Lazaro, C. I., Sayon-Orea, C.,

Toledo, E., Moreno-Iribas, C., Cosials, J. B., Reyero, J.

B., Martínez, J. D., Diego, P. G., Uche, A. M. G., Setas,

D. G., Vila, E. M., Martínez, M. S., Tornos, I. S., &

Rueda, J. J. V. (2020). Risk for cardiovascular disease

associated with metabolic syndrome and its components:

a 13-year prospective study in the RIVANA cohort.

Cardiovascular Diabetology, 19(1), 1–14.

https://doi.org/10.1186/s12933-020-01166-6

Iso, H., Cui, R., Takamoto, I., Kiyama, M., Saito, I.,

Okamura, T., Miyamoto, Y., Higashiyama, A., Kiyohara,

Y., Ninomiya, T., Yamada, M., Nakagawa, H., Sakurai,

M., Shimabukuro, M., Higa, M., Shimamoto, K., Saito,

S., Daimon, M., Kayama, T., … Kadowaki, T. (2021).

Risk classification for metabolic syndrome and the

incidence of cardiovascular disease in japan with low

prevalence of obesity: A pooled analysis of 10

prospective cohort studies. Journal of the American

Heart Association, 10(23). https://doi.org/10.1161/

JAHA.121.020760

Lee, Y. H., & Park, S. (2023). Genetic and Lifestyle-Related

Factors Influencing Serum Hyper-Propionylcarnitine

Concentrations and Their Association with Metabolic

Syndrome and Cardiovascular Disease Risk.

International Journal of Molecular Sciences, 24(21).

https://doi.org/10.3390/ijms242115810

Li, C., He, J., Wei, B., Zhang, X., Wang, X., Zhang, J., Wang,

K., Hu, Y., Mu, L., Yan, Y., Ma, J., Song, Y., Guo, H.,

Ma, R., & Guo, S. (2020). Effect of metabolic syndrome

on coronary heart disease in rural minorities of Xinjiang:

A retrospective cohort study. BMC Public Health, 20(1),

1–8. https://doi.org/10.1186/s12889-020-08612-w

Ntougou Assoumou, H. G., Pichot, V., Barthelemy, J. C.,

Celle, S., Garcin, A., Thomas, T., & Roche, F. (2023).

Obesity related to metabolic syndrome: comparison of

obesity indicators in an older french population.

Diabetology and Metabolic Syndrome, 15(1), 1–7.

https://doi.org/10.1186/s13098-023-01078-x

Salari, N., Doulatyari, P. K., Daneshkhah, A., Vaisi-Raygani,

A., Jalali, R., Jamshidi, P. kord, Abdi, A., Mohammadi,

M., & Kazeminia, M. (2020). The prevalence of

metabolic syndrome in cardiovascular patients in Iran: a

systematic review and meta-analysis. Diabetology and

Metabolic Syndrome, 12(1), 1–10. https://doi.org/10.11

86/s13098-020-00605-4

Zheng, S., Wang, Z., Yang, L., & Zhang, X. (2023). Clinical

correlates and thyroid hormones of metabolic syndrome

in first-episode and drug-naïve major depressive disorder

outpatients with and without hyperglycemia: a

comprehensive cross-sectional study. BMC Psychiatry,

23(1), 1–8. https://doi.org/10.1186/s12888-023-05150-8

Zolghadrpour, M. A., Karimpour, F., Jowshan, M. R., Imani,

H., & Asghari, S. (2023). The effect of a new developed

synbiotic yogurt consumption on metabolic syndrome

components, oxidative stress status, and some other

cardiovascular disease risk factors in adults with

metabolic syndrome: a study protocol for a randomized

clinical trial. BMC Nutrition, 9(1), 1–6.

https://doi.org/10.1186/s40795-023-00723-y

ISCP UTA ’45 JAKARTA 2023 - THE INTERNATIONAL SEMINAR AND CALL FOR PAPER (ISCP) UTA ’45 JAKARTA

164