Management of the metabolic syndrome.

The metabolic syndrome is most commonly defined as the presence of three or more of the following atherogenic risk factors: increased abdominal waist circumference, hypertriglyceridemia, low serum high-density lipoprotein level, raised blood pressure, and a fasting blood sugar level greater than 110 mg/dL. It is associated with increased risk for the development of atherosclerosis and cardiovascular disease. Current management recommendations promote therapeutic lifestyle changes (mainly diet and exercise) for all of the core elements of the syndrome. Pharmacologic therapy is indicated in most patients with atherogenic dyslipidemia and in some with hyperglycemia and raised blood pressure. These therapeutic measures are able to favorably modify the core components of the metabolic syndrome and it is hoped that they will also improve the long-term cardiovascular prognosis in patients with this disorder.