Metabolic Syndrome :: Pharmacist-driven outreach lowers metabolic syndrome rates

Adults who met with pharmacists or pharmacy students during a community outreach and screening project about metabolic syndrome, returned four months later with lower risk factors for heart disease, researchers reported today at the American Heart Association?s 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

Metabolic syndrome is a cluster of cardiovascular disease and diabetes risk factors including excess waist circumference, high blood pressure, elevated triglycerides, low levels of high-density lipoprotein (HDL) and high fasting glucose levels. The presence of three or more of the factors increases a person?s risk of developing diabetes and cardiovascular disease.

“The purpose of our study was to educate people about the metabolic syndrome, because it is not a term used often in the lay public,” said Amy M. Franks, Pharm.D., lead author of the study and assistant professor in the College of Pharmacy at the University of Arkansas for Medical Sciences in Little Rock. “Our hope was that if we educated people about their individual risks for metabolic syndrome and suggested ways to reduce those risks, we would make a positive impact on heart disease risk in the community.”

A group of pharmacists and pharmacy students held individual educational sessions on the metabolic syndrome with 112 people (average age 45 years) employed by a public school in a town near Little Rock.

“We did a clinical screening that measured each one of the five risk factors for metabolic syndrome, then sat with each person to talk about their risk and what they could do to lower their overall risk for heart disease,” Franks said. “When it was necessary, we referred them to their regular healthcare provider to talk about drug therapy or other things they could implement.”

Seventy-three of the participants returned four months later to determine if the pharmacists made an impact in health status.

Initially, the researchers found that about 30 percent of study participants had the metabolic syndrome.

“When we went back four months later, only 18 percent of them met the criteria for metabolic syndrome,” Franks said.

The participants significantly reduced their total cholesterol during the four months, from an average of 197 milligrams per deciliter (mg/dL) to 189 mg/dL. Average systolic (top number) blood pressure dropped from 123 millimeters of mercury (mmHg) to 117 mmHg and diastolic (bottom number) dropped from 79 mmHg to 72 mmHg.

Researchers didn?t find significant changes in the amount of exercise or positive dietary changes reported by participants at the four-month assessment; however, at the follow-up, an additional 7 percent of participants reported initiating drug therapy to combat high blood pressure and 12 percent started taking medication to lower triglycerides, Franks said.

The researchers noted particularly significant changes among those at the highest risk for heart disease. While 50 percent of participants had total cholesterol greater than 200 mg/dL at the start of the study, only 41 percent met that high-risk criterion at the four-month mark.

“The more striking numbers were in blood pressure,” Franks said. “When we looked at systolic blood pressure greater than 140 mmHg, 23 percent of the participants met this high-risk criterion at the start and only 14 percent later. And while 26 percent of the participants had a diastolic reading of higher than 90 mmHg at the study?s start, only 7 percent had such high diastolic pressures by four months.”

The researchers concluded that healthcare providers, including pharmacists, can help combat the components that make up the metabolic syndrome by educating patients and making lifestyle recommendations, Franks said.

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