Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Cardiometabolic disease is a group of related health conditions that impact the heart and metabolism (type 2 diabetes, obesity, high blood pressure, and cardiovascular disease). All of these conditions severely risk life-threatening events like heart attacks and strokes, making cardiometabolic disease one of the most significant health concerns in the world today. With the increasing number of sedentary lifestyles, poor diets, and the increasing levels of stress, the list of affected individuals is increasing. It is important to know what cardiometabolic disease is, why it develops, and how to prevent it to ensure long-term health and decrease the burden of chronic disease.

What Is Cardiometabolic Disease?

Cardiometabolic disease is a group of interconnected health conditions that elevate the risk of more severe cardiovascular problems, such as heart attack and stroke, and type 2 diabetes. Metabolic dysfunction, especially insulin resistance, tends to drive these conditions. 

What Conditions Fall Under Cardiometabolic Disease?

Cardiometabolic disease is a family of interrelated diseases occurring as a result of metabolic and cardiovascular problems. The best known conditions are: 

• Cardiovascular disease: A wide term to denote diseases of the heart and blood vessels. They are coronary artery disease, heart attack, heart failure, and stroke.
• Type 2 diabetes and prediabetes: High sugar levels in the body because of insulin resistance, when cells in the body do not react to insulin properly.
• Chronic kidney disease (CKD): A disease in which the kidney performance fades slowly. It is often combined with diabetes and hypertension, and exacerbate other cardiometabolic disorders.
• Metabolic syndrome: It is diagnosed when an individual has three or more of the following:
  • Abdominal obesity: Excess fat around the waist.
  • High triglycerides: A type of fat found in the blood.
  • Low “good” HDL cholesterol: A type of cholesterol that helps remove other forms of cholesterol from your bloodstream.
  • High blood pressure (hypertension): Persistently high force of blood against the artery walls.
  • High blood sugar: A precursor to prediabetes and type 2 diabetes.
• Nonalcoholic fatty liver disease (NAFLD): This condition is associated with fat accumulation in the liver and is not linked to excessive alcohol consumption.
• Obesity: Obesity (particularly central/abdominal) is regarded as a major cause of numerous other cardiometabolic disorders.
• Dyslipidemia: Lack of balance of lipids (fats) in the blood such as high triglycerides as well as high bad (LDL) cholesterol. 

The occurrence of one or more of these conditions can elevate the risk of others and cause a more serious outcome, which is why all these risk factors should be managed.

What Causes Cardiometabolic Disease?

A complicated combination of genetic, lifestyle and environmental agents causes cardiometabolic disease, which results in metabolic dysfunction and insulin resistance is a central factor. Key contributors include: 

Genetic and biological factors

• Genetic predisposition: A family history substantially risk of development of cardiometabolic disorders such as obesity, insulin resistance, and hypertension.
• Insulin resistance: This is a symptom of the cardiometabolic disease; the body cells are unresponsive to insulin. Body fat, especially the abdominal fat, is a significant cause of insulin resistance.
• Chronic inflammation: A state of inflammation in the body caused by too much fat tissue contributes to insulin resistance and damages the walls of blood vessels.
• Hormonal changes: The synthesis of hormones involved in metabolism in the body, such as leptin and adiponectin, may also be affected, which also adds to insulin resistance.
• Dyslipidemia: Abnormal blood lipids, like elevated triglycerides and low-density lipoprotein (HDL) cholesterol, predispose. 

Lifestyle and environmental factors

• Poor diet: Diets rich in calories, saturated and trans fats, added sugars, and sodium, and low in fruits and vegetables, contribute to the growth of obesity and insulin resistance.
• Physical inactivity: An inactive lifestyle is a major risk factor, because exercise can positively impact insulin sensitivity and other cardiometabolic risk factors.
• Obesity: Excess body fat, particularly abdominal, is a significant source of cardiometabolic risk factors such as insulin resistance, hypertension, and inflammation.
• Stress: Systemic inflammation and cardiometabolic disease can be promoted by chronic psychosocial stress and toxic environmental stress, such as air pollution.
• Sleep patterns: Abnormal sleep duration, including less than 7 hours or over 9 hours of sleep per night, has been associated with high rate of cardiometabolic illnesses.
• Tobacco and alcohol use: Smoking and heavy drinking can elevate blood pressure and cholesterol, thereby risking the development of cardiometabolic complications. 

Interconnections

The personal risk factors tend to interact in a compounding response that enhances the risk. As an example, obesity may cause insulin resistance, which in turn may cause high blood pressure and abnormal cholesterol, culminating in the risk of a heart attack or stroke.

Signs and Symptoms You Shouldn’t Ignore

Cardiometabolic disease is a group of metabolic diseases that predispose to heart attack and stroke. The symptoms and signs of a cardiometabolic disease are usually associated with metabolic and cardiovascular abnormalities.

Common Signs and Symptoms

• Hypertension (usually more than 130/80 mmHg)
• High blood sugar level (100 mg/dL and over)
• Higher waist circumference (apple-shaped; over 40 inches in men, over 35 in women)
• Abnormal cholesterol levels: high triglycerides (>150mg/dL), low HDL cholesterol (<40mg/dLin men, <50mg/dLin women)
• Impaired glucose tolerance and insulin resistance can lead to thirst, frequent urination, fatigue, and blurred vision.
• Angina or other cardiovascular disease-related chest pain or discomfort.
• Heart dysfunction can cause shortness of breath and fatigue.
• Narrowed blood vessels cause pain, numbness, weakness, or coldness in limbs.
• Symptoms indicating abnormal heart rhythm, like palpitations, dizziness or fainting.
• Alterations in urine production and inflammatory stress indicators.

Main risk factors

Several lifestyle and biological factors can increase a person’s risk for cardiometabolic disease: 

• Unhealthy diet
• Physical inactivity
• Obesity
• Excessive alcohol consumption
• Smoking
• Family history and genetics
• Increasing age

Prevention and treatment

Prevention and management may include active lifestyle changes: 

• Dietary supplementation: Emphasizing nutritious food and portions.
• Increasing exercise: Exercising regularly may help manage weight and sugar levels.
• Weight loss: Weight loss, even in small amounts, can be of great health benefit.
• Drugs: Prescription medications are possible to regulate blood pressure, cholesterol, or sugar levels.
• Avoiding alcoholism and cigarette use.
• Managing stress. 

It is important to identify the risk factors at the initial stages to minimize the possibility of developing severe complications.

You may also like to read: Link between Diabetes and Heart Disease

Treatment and Management Options

Cardiometabolic disease is treated and managed to decrease risk factors and stop cardiovascular events by lifestyle changes, pharmaceuticals, and occasionally surgery.

Lifestyle Interventions

• Physical exercise: Moderate exercise taken regularly enhances insulin sensitivity, blood pressure, and lipid profiles.
• Weight control: Dietary and physical weight loss may lower cardiometabolic risk to a great extent.
• Diet: A heart-healthy diet eliminates saturated fats, trans fats, salt, and sugars, and includes abundant fruits, vegetables, whole grains, and lean proteins.
• Cessation of smoking and alcohol moderation are essential in lowering general cardiovascular risk.

Pharmacological Treatments

• Blood pressure management: ACE-inhibitor, ARB, beta-blocker and diuretic antihypertensive drugs.
• Lipid control: Statins and other lipid-lowering medications to lower LDL cholesterol and triglycerides.
• Glycemic regulation: Metformin, SGLT-2, and GLP-1 receptor agonist antidiabetic drugs are used to regulate blood sugar and minimize cardiovascular risks.
• Drugs can also treat prothrombotic conditions and inflammation related to cardiometabolic disease.

Surgical and Procedural Interventions

• In selected cases with severe obesity, bariatric surgery may be considered.
• Revascularization procedures may be necessary for advanced coronary artery disease.

Ongoing Monitoring and Risk Factor Management

• Periodic blood pressure, blood sugar, lipid, and waist circumference measurements.
• Treating other conditions like sleep apnea, stress, and mental health can also enhance the results.
• Individualized strategies that incorporate patient preferences and comorbidities promote efficacy.

Treatment involves a multidisciplinary approach that incorporates lifestyle change, medications, and occasionally surgery in order to reduce cardiovascular risk and enhance metabolic health.

Final Thoughts

In conclusion, cardiometabolic disease represents a growing global health concern, but it is largely preventable with the right approach. A balanced diet, physical activity, healthy weight, and regular health checks all help people dramatically decrease the risk. Prevention of severe complications depends on early diagnosis and proactive treatment of diseases such as diabetes, high cholesterol, and hypertension. The current understanding of cardiometabolic disease is paramount to protect the health of the heart and enhance overall well-being in the future.

FAQs

What are the top 3 metabolic diseases?

Metabolic syndrome is set of disorders that pose the risk of heart disease, stroke and type 2 diabetes. These are high blood pressure, high blood sugar, excess fat around the waist and high cholesterol or triglyceride levels.

What part of the body does cardiometabolic disease affect?

Cardiometabolic diseases refer to a range of prevalent yet frequently preventable diseases such as heart attack, stroke, diabetes, insulin resistance and non-alcoholic fatty liver disease. The number of people who experience one or more of these conditions in their lifetime is on the rise across the globe.

Is hypertension a cardiometabolic disease?

The components of the cardiometabolic syndrome include insulin resistance/hyperinsulinemia, central obesity, dyslipidemia, hypertension, microalbuminuria, increased inflammation, and oxidative stress.