Screening for chronic conditions

The Médicobox Health Passport is a highly accessible way for users to tap into a wide range of helpful tools to screen and monitor common chronic conditions that often go unnoticed because of their asymptomatic nature. These include:

Metabolic syndrome

Metabolic syndrome is not a disease. It is a group of physiological and metabolic factors that significantly increase the risk of type 2 diabetes, heart disease and stroke among people who show three or more of the designated traits:

Obesity

Excess weight, with a particular focus on abdominal obesity.

Hypertension

Abnormally high blood pressure.

Dyslipidemia

Low levels of “good” cholesterol (HDL).

Hypertriglyceridemia

High levels of fatty substances in the blood.

Hyperglycemia

Abnormally high blood glucose.

Each of these is considered to be a risk factor and a potential source of complications, but the presence of three or more indicates a case of metabolic syndrome, which makes an individual three times as likely to develop type 2 diabetes, heart disease or stroke.

Statistics

In Canada, an estimated 6 million Canadians (21% of the adult population) exhibited signs of metabolic syndrome in 2012–2013. The likelihood of developing the syndrome increases with age: 25% in adults aged 40 to 59, and 39% in the 60-to-79 age group. Men and women are equally at risk.

Among the risk factors for metabolic syndrome, abdominal obesity is the most common (92%). The incidence of other factors varies depending on age group. For example, high blood pressure is the least prevalent among adults aged 18 to 39, but leaps to nine adults out of ten in the 60-to-79 group.

Screening and treatment

Other than obesity, for which the physical signs are fairly clear, the factors associated with metabolic syndrome are virtually impossible to detect without testing.

Initial screening and regular follow-up testing (frequency varies according to the number, level and nature of the identified risks) is important in keeping these factors at bay and in determining the required corrective action to reduce their impacts, through medication and other strategies.

Some of these factors are genetic, but most of them are directly related to lifestyle. Sedentary activity and a high-calorie, low-nutrient diet are often to blame for a diagnosis of metabolic syndrome.

But the good news is that, once the condition has been identified, your doctor can prescribe medication and other therapies to help you minimize the overall risks to your health.

Abdominal obesity

Abdominal obesity, i.e., an excess amount of fat around the waist, is a major risk factor that can contribute to the development of type 2 diabetes and high blood pressure and can increase the chances of having a stroke.

Although body mass index is frequently used as a reference test to screen for excess weight, it does not indicate how fat is distributed throughout the body. This is an important piece of information: several studies have shown that subjects with elevated obesity around the midsection (android fat distribution) are up to two times as likely to suffer from heart problems as those with accumulated fat around the hips and thighs (gynoid fat distribution).

Risks and damage

Beyond the increased risk of type 2 diabetes, hypertension and stroke, central obesity can lead to sleep apnea, fat accumulation in the blood and liver (including fatty liver disease) and certain types of cancer (specifically breast, prostrate and colon).

Statistics

Figures from 2014 show that overweight and obesity currently affect 40% of men and 27.5% of women.

Although general overweight statistics have remained stable in recent years, there has been a notable increase in obesity among Canadians 18 and over, which now accounts for 20.2% of the adult population. These obesity rates among men (21.8%) and women (18.7%) are climbing steadily, up from 16% and 14.5%, respectively, in 2003.

Type 2 diabetes

Type 2 diabetes is characterized by chronic hyperglycemia, or high blood sugar, which is attributable to two factors:

Accumulation of fat in the abdominal organs, leading to insulin resistance

Insufficient insulin production

Both result in elevated blood sugar levels.

Risks and damage

When not properly controlled, type 2 diabetes can cause serious, and sometimes irreversible, health problems.

Hyperglycemia weakens the walls of the blood vessels that supply oxygen and nutrients to vital organs and tissues. The heart, nervous system, kidneys, eyes and other parts of the body can suffer as a result.

Untreated type 2 diabetes may therefore lead to permanent vision loss, nerve and kidney damage, and increased risk of stroke.

Statistics

Type 2 diabetes accounts for 90% of all cases of diabetes worldwide. The number of people diagnosed with type 2 diabetes is projected to grow from 285 million to 438 million in the next two decades, according to the latest figures released by the International Diabetes Federation.

In Canada, an estimated 9 million people have diabetes or pre-diabetes, with 20 new cases identified every hour. And many more go undiagnosed.

Diabetes Quebec estimates that 830,000 people in the province, or 10% of the population, have diabetes, including 250,000 who are unaware of it.

Although this type of diabetes is most commonly found in adults over the age of 40, the number of cases diagnosed in children and teenagers in recent years has been increasing at a steady pace.

Hypertension

Arterial hypertension is a cardiovascular disease that occurs when blood exerts abnormally high pressure on blood vessel walls, which in turn forces the heart to work harder to pump blood.

Although high blood pressure can be related to other medical problems (e.g., renal artery stenosis, kidney disease, adrenal gland disorder), the cause in most cases can be difficult to pin down because so many factors are involved. This is known as essential or primary hypertension. Although age and heredity can play a major part, other lifestyle factors, such as obesity, lack of physical activity, a high-salt diet, smoking, excessive drinking and stress, are also key contributors.

In many instances, high blood pressure is “silent” (asymptomatic). In other words, many people have it but don’t know it.

Although hypertension cannot be cured per se, it is possible to control it with medication and healthy lifestyle changes.

Risks and damage

High blood pressure is the leading risk factor for stroke and a major risk factor for heart disease (heart failure, arrhythmia, left ventricular hypertrophy, etc.).

The weakening of the arteries associated with high blood pressure can lead to problems in the kidney (renal failure) and eyes (retinal lesions that may result in a loss of eyesight).

Statistics

In 2014, a survey revealed that 17.7% of Canadians 12 and over are living with a high blood pressure diagnosis. This rate increases considerably with age, hitting the 30% mark in the 55+ age group.

The same survey findings showed that hypertension is much more common among Canadian adults suffering from obesity, for whom the diagnosis rate is 32.7%.

The country-wide prevalence of high blood pressure has been trending upward since 2001.

Dyslipidemia

Dyslipidemia refers to a condition where there is an imbalance of fats – specifically LDL cholesterol and/or triglycerides – in the blood.

Hypercholesterolemia (known colloquially as “high cholesterol”) is a specific form of dyslipidemia characterized by abnormally high levels of LDL (“bad”) cholesterol.

Heredity, diet and lifestyle are the main contributing factors to hypercholesterolemia, although other things like liver malfunction can affect the diagnosis as well.

Secondary causes of hypercholesterolemia include hypothyroidism, chronic kidney failure and nephrotic syndrome.

Risks and damage

Dyslipidemia is generally asymptomatic until complications, many of which can be serious, arise.

Abnormally high levels of fat in the blood contribute to hardening and thickening the coronary arteries, thus affecting their capacity to adapt to physical effort. High LDL cholesterol can also contribute to the formation of blood clots in the veins (thrombosis), which can lead to blocked arteries and heart attack.

Dyslipidemia is also associated with an increased risk of stroke and peripheral arterial disease.

Statistics

Hypercholesterolemia is an asymptomatic condition. The Canadian Health Measures Survey (CHMS) has nevertheless determined that 19% of Canadians 18 to 79 are living with unhealthy LDL (“bad” cholesterol) levels and 16%, with unhealthy HDL levels

The same study revealed that only 51% of people with dyslipidemia were aware of their condition.

It is important to emphasize that heart disease and stroke, two of the three leading causes of death in Canada, are strongly linked to dyslipidemia.