IJCS | Volume 33, Nº3, May / June 2020

However, when abdominal obesity measurements, such as waist circumference or waist-hip ratio, are included as a measure of abdominal adiposity, a strong association with cardiovascular and metabolic syndrome RFs is found. 6 Therefore, it is important to measure the waist circumference in the patient's routine examination. Evidence shows that one of the single most important lifestyle changes for the prevention of many chronic diseases is exercise. For this reason, exercise is now recognized as a medical treatment to improve quality of life and functioning in the elderly. There is growing evidence that regular and consistent exercise significantly reduces abdominal fat deposits, independent of weight loss . 7 A systematic review and meta-analysis were conducted by Ostman et al. to determine whether exercise reversed various indices of metabolic syndrome, including body composition, blood cholesterol, fasting blood glucose, fasting insulin, blood pressure and clinical outcome. When the combined exercise group was compared with the control group, the mean difference of: waist circumference was − 3.80 cm (95% CI − 5.65, − 1.95,  p  < 0.0001); systolic blood pressure was − 3.79 mmHg (95% CI − 6.18, − 1.40,  p = 0.002); and HDL was 0.14 (95% CI 0.04, 0.25,  p  = 0.009). The improvements in waist measurement would suggest that the long-term risks associated with MS were reduced, although the program needs to be tailored to the individual whilst aiming to deliver optimal effects. 8 Due to population characteristics, further and larger studies are required to improve the diagnosis and treatment of MS in older adults and, consequently, reduce the cardiovascular risk of this growing and vulnerable population. 1. Sociedade Brasileira de Cardiologia. Sociedade Brasileira de Endocrinologia e Metabologia. Sociedade Brasileira de Diabetes. Sociedade Brasileira para Estudos da Obesidade. I Diretriz Brasileira de Diagnóstico e Tratamento da Síndrome Metabólica. Arq Bras Cardiol. 2005;84(supl 1):1-28. 2. Park Y-W, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB. The metabolic syndrome: prevalence and associated risk factor findings in theUS population from the thirdNational Health and nutrition examination survey, 1988-1994. Arch Intern Med. 2003;163(4):427–36. 3. Saad MAN, Cardoso GP, Martins WA,Velarde LG, Cruz Filho RA. Prevalence of Metabolic Syndrome in Elderly and Agreement Among Four Diagnostic Criteria. Arq Bras Cardiol. 2014;102(3):263-9. 4. Ruderman NB, Schneider SH, Berchtold P. The "metabolically-obese," normal-weight individual. Am J Clin Nutr. 1981;34(8):1617–21 5. Almeida AC, Oliveira CC, Costa ED, Deiró AQ. Association between Central Obesity and Biochemical Markers of Cardiometabolic Risk in ElderlyAttended in GeriatricAmbulatory – Lagarto/SE. Int J Cardiovasc Sci. 2020;33(3):245-251. 6. Brooks GC, Blaha MJ, Blumenthal RS. Relation of C-reactive protein to abdominal adiposity. Am J Cardiol. 2010;106(1):56–61. 7. Davidson LE, Hudson R, Kilpatrick K, Kuk JL, McMillan K, Janiszewski PM, et al. Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial. Arch Intern Med. 2009;169(2):122–31. 8. Ostman C, Smart NA, Morcos D, Duller A, Ridley W, Jewiss D. The effect of exercise training on clinical outcomes in patients with the metabolic syndrome: a systematic review and meta-analysis. Cardiovasc Diabetol 2017;16(1):110. References 253 Freitas & Mohallem Metabolic Syndrome Int J Cardiovasc Sci. 2020; 33(3):252-253 Editorial This is an open-access article distributed under the terms of the Creative Commons Attribution License