Objectives in the Management of Individuals with MetS

Patients with MetS have a 1.5- to 3-fold increase in the risk of coronary heart disease and stroke.3 The NCEP ATP III guidelines emphasize the importance of treating patients with MetS to prevent CVD.14 The association between MetS and CVD raises important questions about the underlying pathological process(es), especially for designing targeted therapeutic interventions. Cardiovascular risk reduction in individuals with MetS should include at least three levels of intervention: (1) control of obesity and lack of physical activity; (2) control of insulin resistance; and (3) control of the individual components of MetS, especially hypertension and atherogenic dyslipidaemia.14,15

MetS can precede and is often associated with type 2 diabetes.3 Because of this intimate relationship, appropriate management of MetS should be able to prevent the progression from impaired glucose tolerance to frank diabetes and thus to prevent type 2 diabetes. The importance of prevention of diabetes in high-risk individuals (such as people with MetS are) is highlighted by the substantial and worldwide increase in the prevalence of diabetes in recent years.5,10

Owing to the complex pathophysiology and phenotypic expression of MetS, lifestyle changes are crucial as they are able to positively and simultaneously influence almost all components of the syndrome. If such measures are not sufficient or not adequately followed, a pharmacological intervention should be considered.15

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