Metabolic Syndrome: Heart Health


Fast food meals, sitting at a desk or in front of a computer for hours a day, spending hours in the car running the kids around, grabbing dinner on the run and collapsing at the end of the day. Sound like your life?

If so, you could be one of the millions of women who are at risk for developing the metabolic syndrome, a cluster of risk factors for heart disease and diabetes. A “syndrome” means that this is a collection of health risks, not a disease itself.

The National Cholesterol Education Program has defined five elements of the syndrome:

  • an “enlarged waist” – defined as waist measurement of at least 35.2” for women, 40” for men
  • high blood pressure - 130/85 or higher
  • low levels of good (HDL) cholesterol - less than 50 mg/dl for women and less than 40 mg/dl for men
  • elevated levels of blood fats (triglycerides) - 150 mg/dl or more
  • insulin resistance - blood glucose (sugar) level is higher than normal, or a fasting blood glucose of 110 mg/dl or more.

An individual with three or more of these five characteristics has the metabolic syndrome.

Experts in cardiovascular disease and diabetes haven’t figured out the cause of the metabolic syndrome yet. What they do know is that women with the metabolic syndrome have a three times higher risk of dying from a heart attack or stroke, compared with women who don’t have it, and they have a nine to 30 times greater risk of type 2 diabetes.

According to a study published in the Journal Circulation, the worst combination appears to be enlarged waist and high triglyceride levels – those women have almost five times the risk of dying from a heart attack or stroke compared to normal women.

Being overweight automatically puts a woman at risk for developing metabolic syndrome. But smoking, being post-menopausal, inactive and eating a high-carbohydrate diet also increases your chances of developing the syndrome, and certain ethnic groups such as Hispanics are at higher risk than Caucasians.

Management and Treatment

So what’s a woman to do?

If your tape measure and scale have you concerned, start by seeing your doctor for a thorough physical. Your family health history, blood tests, and a blood pressure measurement will tell the story.

The good news is that losing weight by diet and exercise will reduce the risks associated with the metabolic syndrome. And neither the weight loss nor the exercise has to be drastic to be effective. The American Heart Association recommends losing 7 to 10 percent of your starting weight over a period of six months to a year. For example, a woman who weighs 180 pounds would have a weight loss goal of about 12 ½ to 18 pounds.

Keep in mind that what you eat is as important as how much. A low-fat, low-cholesterol, low-sodium diet that includes lots of fruits and vegetables and whole grains will help manage your weight, reduce your blood fat and cholesterol levels and improve your insulin resistance.

Women and people assigned female at birth (AFAB) are usually the main food shoppers in the family, so you are in control of what goes into your shopping basket - and, ultimately, your pantry. Taking charge of your eating habits begins in the grocery store.

It’s no secret that exercise improves your heart and circulation system, and that will reduce the cardiovascular risks associated with the metabolic syndrome. Exercise doesn’t have to be strenuous to be effective – 30 minutes a day of brisk walking will do the trick.

Can’t fit in 30 minutes every day between work, the kids and the house? Start with three days a week and add whatever supplemental activity you can (take the stairs, park far away from the door at the grocery store, or take a brisk tour of the mall).

Your goal is to find a level of activity that you can stick with over the long haul. Try to gradually increase your walking time and include other active pursuits like biking, golfing, using a treadmill or resistance training. (Tip: weight-bearing exercise like walking and resistance training also helps prevent osteoporosis.) If you have heart disease, speak to your doctor before beginning an exercise program.

If you make a serious effort to eat healthier and increase your activity level, you’ll probably also improve your blood pressure, your blood fat and cholesterol levels and your insulin resistance. In the event lifestyle changes don’t improve these numbers sufficiently, your physician may prescribe drug therapy for at least a period of time to get them under control.

Your doctor can tell you if you have the metabolic syndrome. Then it’s up to you to do something about it.


More Information

For more information about women and the metabolic syndrome, call the Miller Family Heart, Vascular & Thoracic Institute Resource and Information Center Nurse at 216.445.9288 or toll-free 866.289.6911. To make an appointment with a Preventive Cardiology specialist, call 216.444.9353, or toll-free 800.223.2273, ext. 4-9353. Preventive Cardiology can assess your risk and help you set up a plan to reverse metabolic syndrome.


  • Tanker YB, Bagger YZ, Qin, G, Alexandersen P, Larsen P, Christiansen C. Enlarged Waist Combined With Elevated Triglycerides Is a Strong Predictor of Accelerated Atherogenesis and Related Cardiovascular Mortality in Postmenopausal Women. Circulation 2005; Apr 19;111(15):1883-90.
  • Marroquin O, Kip K, Kelley D, Johnson BD, Shaw L, Bairey-Merz CN, Sharaf B, Pepine C, Sopko G, Reis. Metabolic syndrome modifies the cardiovascular risk associated with angiographic coronary artery disease in women: a report from the Women's Ischemia Syndrome Evaluation. Circulation 2004;109:714 - 721.

Metabolic Syndrome

*A new browser window will open with this link.

The inclusion of links to other websites does not imply any endorsement of the material on those websites nor any association with their operators.

Last reviewed by a Cleveland Clinic medical professional on 12/14/2018.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy