Mark A Silverberg, MD, MMB, FACEP Assistant Professor, Associate Residency Director, Department of Emergency Medicine, State University of New York Downstate College of Medicine; Consulting Staff, Department of Emergency Medicine, Staten Island University Hospital, Kings County Hospital, University Hospital, State University of New York Downstate Medical Center
James, Paul A.; Oparil, Suzanne; Carter, Barry L.; Cushman, William C.; Dennison-Himmelfarb, Cheryl; Handler, Joel; Lackland, Daniel T.; Lefevre, Michael L.; MacKenzie, Thomas D.; Ogedegbe, Olugbenga; Smith, Sidney C.; Svetkey, Laura P.; Taler, Sandra J.; Townsend, Raymond R.; Wright, Jackson T.; Narva, Andrew S.; Ortiz, Eduardo (18 December 2013). "2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults". JAMA. 311 (5): 507–20. doi:10.1001/jama.2013.284427. PMID 24352797.
Another method is to have the individual wear a device that monitors and records the blood pressure at regular intervals during the day to evaluate blood pressure over time. This is especially helpful during the diagnostic process and can help rule out "white coat" hypertension, the high measurements that are sometimes present only when the person is in the doctor's office and not at other times. (See High Blood Pressure: Using an Ambulatory Blood Pressure Monitor on FamilyDoctor.org.)
Stand tall with feet shoulder-width apart. Hold a dumbbell vertically next to chest with both hands cupping the dumbbell head. Lower body as far as you can by pushing hips back and bending knees. Pause, then push back to the starting position and repeat, keeping weight in heels, not toes, during the entire movement. Elbows should point down to the floor and brush insides of knees as you lower.
This is an incredibly important, but commonly overlooked factor that heavily influences a metabolic resistance training program's success. While you can usually get by with minimal equipment with a MRT program, body weight only can get old very quickly.  Fortunately, just adding a kettlebell, band, suspension trainer, barbell, or other implement can quickly expand your exercise selection pool.  It's important to realize that a little bit can go a long way, especially if you're training in a busy gym and can't monopolize pieces of equipment for too long without someone walking off with them! https://www.healthshare.com.au/storage/avatars/35489.png.60x60_q85_box-0,0,256,256.jpg

The good news is that with changes to diet and exercise, you can prevent, control, or even reverse metabolic syndrome. If you don’t, you could develop significant health risks related to the diabetes, heart disease, and stroke as part of the condition. Your risk for metabolic syndrome increases with age, so it’s important to start adjusting your health habits early on.


The body obtains glucose from three main sources: the intestinal absorption of food; the breakdown of glycogen (glycogenolysis), the storage form of glucose found in the liver; and gluconeogenesis, the generation of glucose from non-carbohydrate substrates in the body.[60] Insulin plays a critical role in balancing glucose levels in the body. Insulin can inhibit the breakdown of glycogen or the process of gluconeogenesis, it can stimulate the transport of glucose into fat and muscle cells, and it can stimulate the storage of glucose in the form of glycogen.[60]
Your current healthcare provider may not end up being your future provider, but your current body is yours forever. If you undergo any blood tests or exams, ask for copies of the results so that you can keep them filed away at home. It’s essential that you know your baseline numbers and keep track of the evolution of your health throughout the course of your life.
Medications used to treat diabetes do so by lowering blood sugar levels. There is broad consensus that when people with diabetes maintain tight glucose control (also called "tight glycemic control") – keeping the glucose levels in their blood within normal ranges – that they experience fewer complications like kidney problems and eye problems.[84][85] There is however debate as to whether this is cost effective for people later in life.[86]
The pathogenesis of essential hypertension is multifactorial and complex. [13] Multiple factors modulate the blood pressure (BP) including humoral mediators, vascular reactivity, circulating blood volume, vascular caliber, blood viscosity, cardiac output, blood vessel elasticity, and neural stimulation. A possible pathogenesis of essential hypertension has been proposed in which multiple factors, including genetic predisposition, excess dietary salt intake, and adrenergic tone, may interact to produce hypertension. Although genetics appears to contribute, the exact mechanisms underlying essential hypertension have not been established.

In addition, metabolic syndrome has been implicated in the pathophysiology of several other diseases, including obstructive sleep apnea. Breast cancer has also been linked to metabolic syndrome, possibly through dysregulation of the plasminogen activator inhibitor-1 (PAI-1) cycle. [64] Additional studies have linked metabolic syndrome with cancers of the colon, gallbladder, kidney, and, possibly, prostate gland. [65] Evidence is emerging of an association with psoriasis. [66, 67]
Effective lifestyle modification may lower blood pressure as much as an individual antihypertensive medication. Combinations of two or more lifestyle modifications can achieve even better results.[87] There is considerable evidence that reducing dietary salt intake lowers blood pressure, but whether this translates into a reduction in mortality and cardiovascular disease remains uncertain.[96] Estimated sodium intake ≥6g/day and <3g/day are both associated with high risk of death or major cardiovascular disease, but the association between high sodium intake and adverse outcomes is only observed in people with hypertension.[97] Consequently, in the absence of results from randomized controlled trials, the wisdom of reducing levels of dietary salt intake below 3g/day has been questioned.[96]

^ Brunner EJ, Hemingway H, Walker BR, Page M, Clarke P, Juneja M, Shipley MJ, Kumari M, Andrew R, Seckl JR, Papadopoulos A, Checkley S, Rumley A, Lowe GD, Stansfeld SA, Marmot MG (November 2002). "Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study". Circulation. 106 (21): 2659–65. doi:10.1161/01.cir.0000038364.26310.bd. PMID 12438290.


According to the Centers for Disease Control and Prevention, more than 50% of people age 50 and older have high blood pressure. Women are about as likely as men to develop high blood pressure, though this varies somewhat by age. For people younger than age 45, more men than women are affected, while for those age 65 and older, more women than men are affected. Americans of African descent develop high blood pressure more often and at an earlier age than those of European and Hispanic descent.
The AHA/ASA recommends a diet that is low in sodium, is high in potassium, and promotes the consumption of fruits, vegetables, and low-fat dairy products for reducing BP and lowering the risk of stroke. Other recommendations include increasing physical activity (30 minutes or more of moderate intensity activity on a daily basis) and losing weight (for overweight and obese persons).

Cycle the diet in a way that has periods of reduced energy intake and periods of increased energy intake. This helps offset the leptin decline that occurs with dieting. There is individual variation with this, but for those who respond well, a day or a few days of overeating can set the metabolic rate back to a higher level. This cycling approach may be more effective for fat loss than the traditional approach

^ Xie, X; Atkins, E; Lv, J; Bennett, A; Neal, B; Ninomiya, T; Woodward, M; MacMahon, S; Turnbull, F; Hillis, GS; Chalmers, J; Mant, J; Salam, A; Rahimi, K; Perkovic, V; Rodgers, A (30 January 2016). "Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis". Lancet. 387 (10017): 435–43. doi:10.1016/S0140-6736(15)00805-3. PMID 26559744.
The prevailing opinion is that all of these markers are signs of insulin resistance, meaning the diminished ability of a given amount of insulin to exert its normal effect. When insulin resistance develops, it can impact metabolic processes in many ways, resulting in the specific markers listed above. However, different individuals respond to insulin resistance in different ways. Also, the time frame in which certain signs develop varies. This variability makes defining—and treating—metabolic syndrome tricky.
Metabolic syndrome is a cluster of metabolic risk factors that come together in a single individual. These metabolic factors include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for blood clotting. Affected individuals are most often overweight or obese. An association between certain metabolic disorders and cardiovascular disease has been known since the 1940s.
Type 2 diabetes, a form of diabetes mellitus, is likely one of the better-known chronic diseases in the world — and that's no surprise. Data from the Centers for Disease Control and Prevention suggest in the United States alone, 30.3 million people, or 9.4 percent of the U.S. population, has diabetes, and the majority of these people have type 2. (1)
A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity published a guideline to harmonize the definition of the metabolic syndrome.[39] This definition recognizes that the risk associated with a particular waist measurement will differ in different populations. Whether it is better at this time to set the level at which risk starts to increase or at which there is already substantially increased risk will be up to local decision-making groups. However, for international comparisons and to facilitate the etiology, it is critical that a commonly agreed-upon set of criteria be used worldwide, with agreed-upon cut points for different ethnic groups and sexes. There are many people in the world of mixed ethnicity, and in those cases, pragmatic decisions will have to be made. Therefore, an international criterion of overweight (BMI≥25) may be more appropriate than ethnic specific criteria of abdominal obesity for an anthropometric component of this syndrome which results from an excess lipid storage in adipose tissue, skeletal muscle and liver.
The prevailing opinion is that all of these markers are signs of insulin resistance, meaning the diminished ability of a given amount of insulin to exert its normal effect. When insulin resistance develops, it can impact metabolic processes in many ways, resulting in the specific markers listed above. However, different individuals respond to insulin resistance in different ways. Also, the time frame in which certain signs develop varies. This variability makes defining—and treating—metabolic syndrome tricky.
Dietary factors also influence the risk of developing type 2 DM. Consumption of sugar-sweetened drinks in excess is associated with an increased risk.[46][47] The type of fats in the diet is also important, with saturated fat and trans fats increasing the risk and polyunsaturated and monounsaturated fat decreasing the risk.[45] Eating lots of white rice, and other starches, also may increase the risk of diabetes.[48] A lack of physical activity is believed to cause 7% of cases.[49]
If you’ve been told that you have metabolic syndrome (sometimes called cardiometabolic syndrome), it means that you have several of these health problems. Together, they put you at much greater risk for heart attack, stroke and type 2 diabetes. In general, someone who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as a person who doesn’t have this grouping of health issues. Unfortunately, amid rising obesity rates in the U.S., this syndrome is becoming more common. Alarmingly, one out of 10 teens may have it.

Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections.


To measure your blood pressure, a specialist places an inflatable cuff around your arm and measures your blood pressure using a pressure-measuring gauge. A blood pressure reading, as shown in the blood pressure monitor in the image, measures the pressure in your arteries when your heart beats (systolic pressure) in the first number, and the pressure in your arteries between heartbeats (diastolic pressure) in the second number.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
Whether you reduce calories or lower carbs, one of the first things that occur in dieters is a beneficial change in either the amount and/or sensitivity of the hormone insulin. Insulin also acts as a hunger hormone, so this change, while beneficial, is one of the first and earliest changes resulting in metabolic compensation. This causes increased hunger. Other hormones are also impacted. Cortisol and ghrelin both will be elevated in pulses while dieting. This too causes increased hunger and cravings.
Fasting glucose test This test involves giving a blood sample after you have fasted for eight hours. (18) If you have a fasting blood sugar level of less than 100 milligrams per deciliter (mg/dl), your blood sugar levels are normal. But if you have one from 100 to 125 mg/dl, you have prediabetes, and if you have 126 mg/dl on two separate occasions, you have diabetes. (17)
Hypertension or high blood pressure is a chronic medical condition in which the pressure or tension in the arteries is elevated. It is often called the "silent disease" as it has no symptoms and can go undetected for years, damaging your tissues and vital organs. If you have hypertension, your heart works harder than it should to pump blood to your tissues and organs. If this pressure isn't controlled, your heart enlarges and your arteries become scarred and hardened. Eventually, your overworked heart may not be able to pump and transport blood properly through these arteries. This can result in heart disease, kidney disease, the hardening of the arteries, eye damage, and stroke. Hypertension can be caused by a number of factors including your genes, underlying disease and lifestyle.
Fortunately, since peaking in 2001-2002, the overall prevalence of metabolic syndrome in the United States has fallen, primarily due to decreases in the prevalences of hypertriglyceridemia and hypertension—and in spite of increases in the prevalences of hyperglycemia and obesity/waist circumference. [27]  Data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) showed that the age-adjusted prevalence of metabolic syndrome had fallen to approximately 24% in men and 22% in women. [28]
In hypertensive emergency, there is evidence of direct damage to one or more organs.[27][28] The most affected organs include the brain, kidney, heart and lungs, producing symptoms which may include confusion, drowsiness, chest pain and breathlessness.[26] In hypertensive emergency, the blood pressure must be reduced more rapidly to stop ongoing organ damage,[26] however, there is a lack of randomized controlled trial evidence for this approach.[28]
Because some medications, such as over-the-counter cold medicines, pain medications, antidepressants, birth control pills and others, can raise your blood pressure, it might be a good idea to bring a list of medications and supplements you take to your doctor's appointment. Don't stop taking any prescription medications that you think may affect your blood pressure without your doctor's advice.
The device being used is known as a “sphygmomanometer”, which uses an air-filled cuff wrapped around the upper arm, to obstruct the bloodflow into the arm. By releasing the air pumped into the cuff in small, incremental quantities, eventually blood is permitted to flow back into the arm, at which point, the pressure inside the cuff is measured, and which will equate to the pressure inside the arteries. This pressure, known as the systolic pressure, represents the pressure in the arteries during contraction of the heart. When the heart relaxes between beats the pressure drops, and is known as the diastolic pressure. Together, these two pressures are written as a ratio, and represents ones “blood pressure”.

Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.[10] High blood pressure typically does not cause symptoms.[1] Long-term high blood pressure, however, is a major risk factor for coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral vascular disease, vision loss, chronic kidney disease, and dementia.[2][3][4][11]
Not so anymore. Thanks to the rising obesity epidemic in young people, kids and teens are getting these conditions — and they're getting them earlier than ever before. Some estimates say that nearly 1 in 10 teens — and over a third of obese teens — have metabolic syndrome. And a study of 375 second- and third-graders found that 5% had metabolic syndrome and 45% had one or two risk factors for it.
Insulin is a fat storage hormone, it works to shuttle the sugar from your blood stream into your fat cells to store for later. Insulin has a number of other reproductive functions and has effects on skin health, cravings and the like. Insulin levels naturally increase after eating a meal that contains carbohydrates, dairy or protein. If you are insulin resistant then you can have an elevated level of insulin when you are fasting, or you can experience too much insulin release in response to those foods. This can trap your body in fat storage mode and inhibit fat loss.
Diabetes can also result from other hormonal disturbances, such as excessive growth hormone production (acromegaly) and Cushing's syndrome. In acromegaly, a pituitary gland tumor at the base of the brain causes excessive production of growth hormone, leading to hyperglycemia. In Cushing's syndrome, the adrenal glands produce an excess of cortisol, which promotes blood sugar elevation.

The Caerphilly Heart Disease Study followed 2,375 male subjects over 20 years and suggested the daily intake of a pint (~568 ml) of milk or equivalent dairy products more than halved the risk of metabolic syndrome.[51] Some subsequent studies support the authors' findings, while others dispute them.[52] A systematic review of four randomized controlled trials found that a paleolithic nutritional pattern improved three of five measurable components of the metabolic syndrome in participants with at least one of the components.[53]
Blood pressure was traditionally measured using a stethoscope and a blood pressure cuff (called a sphygmomanometer), a device that includes a cuff, a bulb, and a pressure dial that reads the pressure in millimeters of mercury (mm Hg). This is still considered the best method but, more commonly, devices that combine a blood pressure cuff with electronic sensors are used to measure blood pressure. http://4.bp.blogspot.com/-du4BiwBwloo/UbfEdfaxaSI/AAAAAAAABa4/ikJjD8ruIkw/s1600/claire-kerslake-graphic-for-renew-promo-post-with-logo-final.jpg
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