Episode Details

Episode 71: Metabolic Syndrome. 

Dr Yomi defines metabolic syndrome and describes the basic principles of management. Nathan gives updates about aspirin use in primary prevention of cardiovascular disease.

Introduction: Aspirin Update.  
By Nathan Heathcoat, MS3, Ross University School of Medicine.  

Arreaza (comment): This week I was checking the list of the top 10 countries where we have the highest number of listeners, and I’m happy to see the Kingdom of Spain as the number 2 country with the most listeners. Out top 1 country is the United States, we also have listeners in Canada, Mexico, the Netherlands, Brazil, Ireland, Australia, South Africa, Mexico, and England. I send my greetings to you wherever you are. I hope you all enjoy today’s episode, from wherever you are, and please send us an email to rbresidency@clinicasierravista.org if you have any feedback. We would like to hear from you.

Hello, my name is Nathan Heathcoat I am a 3rd year medical student at Ross University School of Medicine. I will be giving a quick update on aspirin. 

Aspirin has been examined quite a bit by the USPSTF recently. In episode 68, Doctors Arreaza and Civelli discussed the continued recommendations for the use of aspirin for the prevention of preeclampsia in high-risk patients. 

Now as of October 12, 2021, The USPSTF has been working on draft changes on how we utilize aspirin for the prevention of cardiovascular disease (CVD) events.

The previous guideline from 2016 gave aspirin use as CVD event prophylaxis a grade B (as in Bravo) recommendation in patients aged 50-59 who’s 10-year ASCVD risk was 10% or greater. Additionally, for those patients aged 60-69 with a 10-year risk of 10% or more, aspirin use is said to be an individual based approach and received a grade C recommendation. (1)

Now with these new draft recommendations, those patients aged 40-59, aspirin only adds marginal benefit. Its recommendation has been tentatively changed to grade C and its use should be an individual based approach. Most notably, for those patients aged 60-69, the USPSTF is suggesting that aspirin confers no net benefit for primary prevention of CVD, and they changed its recommendation to grade D as in delta. (2)

So going forward keep in mind that these practice guidelines are under draft review and the official recommendation should be finalized mid to late November 2021. 

This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it’s sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. 

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Metabolic Syndrome.    
By Timiiye Dawn Yomi, MD; and Hector Arreaza, MD.  

INTRODUCTION                                                                                                                                                            Obesity, especially abdominal obesity, is associated with an increase in insulin resistance which causes abnormal glucose and fatty acid utilization in peripheral muscles, among other consequences. 

Obesity can often result in type 2 diabetes. 

The hyperinsulinemia and hyperglycemia resulting from insulin resistance can result in vascular endothelial dysfunction, abnormal lipid profile, hypertension, and vascular inflammation and together, can increase the risk for developing ASCVD. 

A constellation of metabolic risk factors for type 2 diabetes and cardiovascular disease is what constitutes metabolic syndrome or insulin resistance syndrome.

What is a syndrome? It is a group of symptoms that are present together, or a condition characterized by a s