METABOLIC SYNDROME - From Risk Factors to Management [Blaha - Seed]
- ISBN/EAN
- 9788897419198
- Editore
- Seed
- Formato
- Brossura
- Anno
- 2012
- Pagine
- 190
Disponibile
15,00 €
L’aumentato apporto calorico dei cibi, il maggior consumo di carboidrati raffinati e l'inattività fisica hanno determinato un’esplosione dell'incidenza dell’obesità addominale in tutto il mondo e a un’epidemia emergente di insulino-resistenza, con conseguente aumento della sindrome metabolica. I medici possono utilizzare il concetto di sindrome metabolica per guidare cambiamenti mirati dello stile di vita, puntare ad abbassare i livelli di pressione sanguigna e intervenire in anticipo con aspirina, farmaci ipolipemizzanti e quando necessario farmaci antiglicemizzanti. L'approccio globale "ABCDE" presentato in questo libro offre uno strumento mnemonico da utilizzare nella pratica clinica quotidiana. In questo testo esclusivo e di facile lettura, vengono presentati i 17 studi clinici più importanti nel campo della sindrome metabolica, che ogni medico dovrebbe conoscere.
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Increased caloric intake, increased refined carbohydrate consumption, and physical inactivity have led to an explosion in the worldwide incidence of abdominal obesity and the emerging epidemic of insulin resistance, resulting in an increase of metabolic syndrome. Physicians can use the metabolic syndrome concept to guide focused lifestyle changes, lower blood pressure goals, and earlier intervention with aspirin, LDL-lowering drugs, and perhaps insulin-sensitizing medications. The comprehensive “ABCDE” approach presented in this book provides a memory tool for use in everyday clinical practice. In this unique, easy-to-read text, the 17 most important clinical trials in the field of the metabolic syndrome are presented, that every clinician should know.
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Maggiori Informazioni
| Autore | Blaha Michael J.; Tota-Maharaj Rajesh |
|---|---|
| Editore | Seed |
| Anno | 2012 |
| Tipologia | Libro |
| Lingua | Inglese |
| Indice | INTRODUCTION...................................................................................................... 7 1 THE METABOLIC SYNDROME. A GLOBAL PROBLEM ............................... 9 1.1 Introduction............................................................................................................10 1.2 A Global Problem..................................................................................................11 1.3 What is the Metabolic Syndrome?..................................................................12 1.4 Why is the Metabolic Syndrome Concept Useful?....................................13 1.5 Misunderstandings about Use of Metabolic Syndrome.........................16 1.6 Why is the Metabolic Syndrome so Interesting?.......................................18 References...............................................................................................................19 2 DEFINING THE METABOLIC SYNDROME.....................................................21 2.1 Early History of the Metabolic Syndrome....................................................21 2.2 Pathophysiology vs. Predictive Value............................................................25 2.3 Criticisms of the Metabolic Syndrome..........................................................27 2.4 The “Harmonized” Definition of Metabolic Syndrome............................30 References...............................................................................................................32 3 CAUSES AND COMPONENTS OF THE METABOLIC SYNDROME........35 3.1 Genetics of the Metabolic Syndrome............................................................35 3.2 Abdominal Obesity..............................................................................................37 3.3 Insulin Resistance .................................................................................................39 3.4 Atherogenic Dyslipidemia.................................................................................40 3.5 Essential Hypertension.......................................................................................41 3.6 Glucose Intolerance.............................................................................................41 3.7 Subclinical Inflammation...................................................................................42 3.8 Fatty Liver Disease................................................................................................42 3.9 Obstructive Sleep Apnea ...................................................................................43 References...............................................................................................................44 4 CONSEQUENCES OF THE METABOLIC SYNDROME ...............................47 4.1 Cardiovascular Disease.......................................................................................47 4.2 Type 2 Diabetes.....................................................................................................53Metabolic Syndrome | From Risk Factors to Management 4 4.3 Microalbuminuria and Chronic Kidney Disease ........................................55 4.4 Sexual Dysfunction (Men and Women)........................................................56 4.5 Cognitive Decline .................................................................................................59 4.6 Cancer.......................................................................................................................59 References...............................................................................................................61 5 THE COMPREHENSIVE “ABCDE” APPROACH TO MANAGEMENT ......63 5.1 Rationale for a Comprehensive Approach...................................................63 5.2 The ABCDE approach ..........................................................................................64 References...............................................................................................................67 6 ASSESSMENT OF CARDIOVASCULAR RISK ................................................69 6.1 Traditional Risk Models.......................................................................................69 6.2 Lifetime Risk............................................................................................................70 6.3 Metabolic Syndrome and Unaccounted Risk .............................................72 6.4 Emerging Cardiometabolic Risk Factors.......................................................73 6.5 Reclassification with the Metabolic Syndrome..........................................74 6.6 Novel Risk Detection Strategies......................................................................74 References...............................................................................................................78 7 ASPIRIN AND ANTITHROMBOTICS ...............................................................81 7.1 Mechanisms of Increased Thrombosis in the Metabolic Syndrome ... 81 7.2 Brief Overview of Platelet Function ...............................................................82 7.3 Therapies With Available Evidence ................................................................84 7.4 Possible Aspirin Resistance in the Metabolic Syndrome........................88 7.5 Other Therapies.....................................................................................................89 7.6 Treatment recommendations..........................................................................90 References...............................................................................................................91 8 BLOOD PRESSURE................................................................................................93 8.1 Hypertension..........................................................................................................93 8.2 Definition.................................................................................................................95 8.3 Mechanisms of Increased Blood Pressure in the Metabolic Syndrome ................................................................................................................95 8.4 Lifestyle Therapy ...................................................................................................97 8.5 Pharmacologic Agents: The Renin-Angiotensin-Aldosterone Axis....98M. J. Blaha, R. Tota-Maharaj 5 8.6 Thiazide Diuretics.............................................................................................. 100 8.7 Beta-Blockers ...................................................................................................... 100 8.8 Calcium Channel Blockers.............................................................................. 100 8.9 Metabolic Considerations. Progression to Diabetes............................. 101 8.10 Blood Pressure Target....................................................................................... 102 8.11 Guidelines and Recommendations............................................................. 102 References............................................................................................................ 104 9 CHOLESTEROL.................................................................................................... 107 9.1 Atherogenic Dyslipidemia.............................................................................. 107 9.2 Mechanisms of Atherogenic Dyslipidemia .............................................. 108 9.3 Measurement...................................................................................................... 110 9.4 Therapies with Available Evidence.............................................................. 111 9.5 Guidelines and Recommendations............................................................. 121 References............................................................................................................ 122 10 DIET AND WEIGHT MANAGEMENT............................................................ 125 10.1 Weight Loss.......................................................................................................... 125 10.2 The Mediterranean Diet.................................................................................. 126 10.3 The Low Glycemic Index Approach............................................................. 129 10.4 Sugar Sweetened Beverages......................................................................... 131 10.5 The Benefit of Nuts............................................................................................ 132 10.6 Pharmacologic and Surgical Therapy for Obesity.................................. 133 10.7 Refer to a Nutritionist? ..................................................................................... 134 References............................................................................................................ 134 11 DIABETES PREVENTION.................................................................................. 137 11.1 Progression to Type 2 Diabetes.................................................................... 137 11.2 Clinical Trial Evidence ...................................................................................... 139 11.3 Gaps in the Evidence........................................................................................ 143 11.4 Guidelines............................................................................................................. 143 References............................................................................................................ 144 12 EXERCISE THERAPY.......................................................................................... 147 12.1 Fitness.................................................................................................................... 147 12.2 Mechanisms of Harm from Sedentary Lifestyle: Decreased Fitness....149Metabolic Syndrome | From Risk Factors to Management 6 12.3 Mechanisms of Harm from Sedentary Lifestyle: Increased Fatness... 151 12.4 Exercise: A Selective Therapy for Metabolic Syndrome? ..................... 153 12.5 Guideline Recommendations....................................................................... 156 References............................................................................................................ 157 13 METABOLIC SYNDROME IN THE PEDIATRIC POPULATION.............. 159 13.1 The Unique Challenge of Pediatric Metabolic Syndrome................... 159 13.2 Defining Pediatric Metabolic Syndrome ................................................... 162 13.3 Scientific Statement from the American Heart Association............... 164 13.4 Population-Based Treatment Strategies Targeted at Youth................ 165 References............................................................................................................ 166 14 SUMMARY OF TREATMENT APPROACHES.............................................. 169 APPENDIX. CLINICAL TRIALS........................................................................ 171 Finnish Diabetes Prevention Study ............................................................. 171 Diabetes Prevention Program (DPP)........................................................... 172 JPAD Trial............................................................................................................... 173 POPADAD Trial .................................................................................................... 174 ACCORD Blood Pressure Trial......................................................................... 175 JUPITER trial......................................................................................................... 176 VA-HIT trial............................................................................................................ 177 ACCORD Lipid trial............................................................................................. 178 AIM-HIGH trial..................................................................................................... 179 JELIS trial............................................................................................................... 180 Lyon Heart Study ............................................................................................... 181 Esposito Mediterranean Diet Trial................................................................ 182 DREAM Trial.......................................................................................................... 183 ACT-NOW Trial..................................................................................................... 184 CANOE trial .......................................................................................................... 185 Tjønna Exercise Trial.......................................................................................... 186 CPAP for the Metabolic Syndrome .............................................................. 187 References............................................................................................................ 188 AUTHORS ............................................................................................................. 191 |
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