Diagnosis
3
➤ 1.2: In individuals aged 40–75 years in the office setting who do not yet
have ASCVD or T2DM and already have at least one risk factor, we advise
screening every 3 years for all five components of metabolic risk as part of
the routine clinical examination. (Ungraded Good Practice Statement)
➤ 1.3: To establish metabolic risk in the general population, ES recommends
that clinicians measure waist circumference as a routine part of the
clinical examination. (1|⊕⊕⊕
)
Technical Remarks:
▶ This measurement does not replace the routine measurement of weight or calculation
of body mass index but can provide more focused information regarding risk for
ASCVD and T2DM.
▶ The writing committee agrees that the cutoffs for elevated waist circumference
should be ≥102 cm for men and ≥88 cm for women in Caucasian, African,
Hispanic, and Native American populations.
▶ The writing committee agrees that the cutoffs for waist circumference in Asian
populations (both East Asian and South Asian) should be ≥90 cm for men and
≥80 cm for women.
➤ 1.4: In individuals previously diagnosed with prediabetes, ES suggests
testing at least annually for the presence of overt T2DM. (2|⊕⊕⊕
)
Technical Remark:
▶ Prediabetes is defined in a variety of ways ( fasting plasma glucose, 2-hour plasma
glucose following a 75-g oral glucose tolerance test, or hemoglobin A1c) by different
organizations in different countries, and the writing committee does not endorse
preferential use of one definition over another.
➤ 1.5: ES recommends that all individuals at metabolic risk in the office
setting have their blood pressure measured annually and, if elevated, at
each subsequent visit. (1|⊕⊕⊕⊕)
Technical Remarks:
▶ Blood pressure should be measured after five minutes of rest.
▶ Ambulatory and/or home blood pressure monitoring, if performed correctly, is
recommended to confirm a diagnosis of hypertension after initial screening.
➤ 1.6: For individuals with elevated blood pressure >130 mmHg systolic
and/or 80 mmHg diastolic who are not documented as having a history of
hypertension, ES recommends confirmation of elevated blood pressure on
a separate day within a few weeks or with a home blood pressure monitor.
(1|⊕⊕⊕⊕)
