What are the NHLBI and AHA diagnostic criteria for metabolic syndrome?

Updated: Mar 30, 2020
  • Author: Stanley S Wang, JD, MD, MPH; Chief Editor: Yasmine S Ali, MD, MSCI, FACC, FACP  more...
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Under 2005 revised guidelines by the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA), [6] metabolic syndrome is diagnosed when a patient has at least three of the following five conditions (see Presentation and Workup):

  • Fasting glucose ≥100 mg/dL (or receiving drug therapy for hyperglycemia)

  • Blood pressure ≥130/85 mm Hg (or receiving drug therapy for hypertension)

  • Triglycerides ≥150 mg/dL (or receiving drug therapy for hypertriglyceridemia)

  • HDL-C < 40 mg/dL in men or < 50 mg/dL in women (or receiving drug therapy for reduced HDL-C)

  • Waist circumference ≥102 cm (40 in) in men or ≥88 cm (35 in) in women; if Asian American, ≥90 cm (35 in) in men or ≥80 cm (32 in) in women (The international diabetes federation [IDF] criteria allow the use of a body mass index [BMI] >30 kg/m2 in lieu of the waist circumference criterion.)

To address variation between professional guidelines, the National Heart, Lung, and Blood Institute (NHLBI), American Hearth Association (AHA), International Diabetes Foundation (IDF), and other organizations have proposed a harmonized definition of metabolic syndrome. [3]

Abundant data suggest that patients meeting these diagnostic criteria have a greater risk of significant clinical consequences, the 2 most prominent of which are the development of diabetes mellitus [7] and of coronary heart disease. Pooled data from 37 studies involving more than 170,000 patients have shown that metabolic syndrome doubles the risk of coronary artery disease. [8] It also increases risk of stroke, fatty liver disease, and cancer. [9] (See Prognosis.)

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