Cardiometabolic disorders and weight: A special report on metabolic syndrome

September 1, 2009

The first in a series of articles on the disorder outlines the major editorial initiative being launched by Advanstar Communications' journals and ModernMedicine.com.

FOR THE FIRST TIME, 17 of Advanstar Communications' Life Sciences publications and its Web portal http://ModernMedicine.com/ are collaborating in a coordinated, interdisciplinary initiative to address a major public health issue-cardiometabolic disorders and weight.

This groundbreaking initiative emphasizes core competencies, best practices, and shared responsibility among all stakeholders in the patient's health-care ecosystem. We investigate cardiometabolic disorders and how they interrelate to significantly increase cardiovascular risk. We provide the tools and information that primary-care physicians, specialists, midlevels, nurses, pharmacists, managed care professionals, and the pharmaceutical industry need to work together to address this growing problem and ultimately improve patient outcomes.

From September through November, the project will be featured on Advanstar's ModernMedicine Network, in our 15 health-care publications-Medical Economics, Contemporary OB/GYN, Contemporary Pediatrics, Geriatrics, Formulary, Drug Topics, Managed Healthcare Executive, Ophthalmology Times, Optometry Times, Dermatology Times, Cosmetic Surgery Times, Urology Times, RN, Healthcare Traveler, Locum Life-and in two of our pharmaceutical publications, Pharmaceutical Executive and Applied Clinical Trials. With 340,00-plus members on the ModernMedicine Network and a combined print and digital edition circulation of more than 1 million, these brands provide the news, analysis, and education that health-care professionals and executives and pharmaceutical industry leaders alike have come to rely on.

The public health impact of cardiometabolic abnormalities becomes clearer when one considers that 38.9% of US adults report a prescription drug expense for a cardiovascular agent and 28.9% report a prescription drug expense for a metabolic agent. Furthermore, metabolic agents are the number 1 type of medication prescribed in the United States, accounting for an expenditure of $38.1 billion annually, and cardiovascular agents rank number 2 at $33.1 billion annually.3

A further complication for healthcare professionals seeking to identify the most appropriate treatment strategies from current guidelines is that the American Diabetes Association (ADA) and the European Association for the Study of Diabetes do not recognize "metabolic syndrome" per se. Instead, they recommend that any patient with one cardiometabolic disorder be screened for the others and that each component disorder be treated to its individual target.8 In addition, current guidelines from the NHLBI-sponsored Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) recommend a lower blood pressure goal for patients with diabetes than does ATP III,9 and current ADA treatment guidelines recommend earlier drug treatment-at the prediabetes level-especially for patients with other risk factors for developing type 2 diabetes, including hypertension, low HDL, elevated triglycerides, and obesity.10

Not only do the various treatment parameters conflict, they are updated often. For example, the NHLBI has convened experts to update both ATP and JNC guidelines, and the proposed new versions are expected to be available for public comment in December 2009. The ADA released its updated clinical practice guidelines earlier this year.10

Our cross-therapeutic approach to addressing this issue provides specific knowledge and practical strategies to improve the treatment of patients with these conditions. This overview describes how cardiometabolic disorders and weight intersect with each therapeutic area/practice setting and outlines the related coverage by our journals and Web sites.