Metabolic syndrome - blood pressure is only one part of it
Metabolic syndrome (= affecting metabolism) is not a disease in its own right. It refers to the coexistence of various diseases or risk factors for cardiovascular disease and diabetes.
The metabolic syndrome, sometimes called the disease of affluence, mainly consists of:
- excess weight (obesity) with fat deposits, particularly around the abdomen
- elevated blood pressure
- elevated blood sugar levels (sugar metabolism is impaired due to reduced insulin sensitivity or insulin resistance)
- impaired fat metabolism
These four symptoms are collectively called "the deadly quartet." The risk of dying from a heart attack or stroke doubles when the metabolic syndrome is present. The risk of developing diabetes is now five times higher than in people without the syndrome of affluence.
About 25 percent of the German population are currently affected and the number is rising. It most commonly affects people over 60, but the symptoms can already appear in children and adolescents.
The four main symptoms
Overweight is also called obesity. In the context of metabolic syndrome, the fat stored in the abdominal area and between the organs is especially important. Experts call this visceral fat. It is very metabolically active and affects both fat and sugar metabolism. To quickly assess the risk, waist circumference is measured at waist level. The cutoff is 88 cm for women and 102 cm for men.
Blood pressure values in the high-normal range or already treated high blood pressure (hypertension) are another feature of the metabolic syndrome. Because high blood pressure by itself already carries a high risk for cardiovascular disease, this risk is greatly increased when combined with other risk factors.
Reduced sensitivity to insulin, or insulin resistance, leads to elevated blood glucose levels. This reveals a dangerous interrelationship between the individual symptoms of metabolic syndrome, as metabolically active visceral fat (see obesity) directly affects sensitivity to insulin: it reduces it. Therefore, elevated blood glucose levels (fasting levels of 110 mg/dl or higher) or pre-existing diabetes mellitus are among the symptoms of metabolic syndrome.
This is characterized by increased triglyceride levels from 150 mg/dl (over 1.7 mmol/l) and reduced levels of (the "good") HDL cholesterol. In women this value is then below 50 mg/dl (under 1.25 mmol/l) and in men below 40 mg/dl (under 1.05 mmol/l). Here too, there is a link with belly fat: it has a more adverse effect on fat metabolism than fat stored, for example, on the thighs.
In addition to these main features, there are several other symptoms that can play a role in the metabolic syndrome. These less well-known factors include, for example, increased uric acid levels, a tendency toward stronger blood clotting, and increased protein excretion in the urine.
Even though metabolic syndrome involves several risk factors that occur together, the basic treatment is the same for all symptoms. The current lifestyle needs to be changed with the goal of reducing body weight or waist circumference. This is achieved by changing eating habits and increasing physical activity. This change not only has a positive effect on waist circumference and weight, but also on blood pressure, blood lipid levels, blood sugar levels, and insulin sensitivity.
Sources
- https://www.springermedizin.de/emedpedia/dgim-innere-medizin/metabolisches-syndrom-praevention-und-therapie?epediaDoi=10.1007%2F978-3-642-54676-1_2
- http://flexikon.doccheck.com/de/Metabolisches_Syndrom
- https://de.wikipedia.org/wiki/Metabolisches_Syndrom
- http://www.netdoktor.de/krankheiten/metabolisches-syndrom/
- https://www.internisten-im-netz.de/de_was-ist-ein-metabolisches-syndrom_647.html
This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 01/2026).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.
