Pharmacological approach to cardiovascular risk in metabolic syndrome.

Metabolic syndrome is not a discrete entity with a single pathogenesis, but different complex mechanisms, especially those inducing oxidative stress, play a major role in the genesis of this condition. This consideration suggests that treatment of recognized cardiovascular risk factors alone cannot be enough to prevent cardiovascular events in patients with a diagnosed metabolic syndrome. However, it has been reported that oxidative stress is involved in the transduction of the effects of haemodynamic and metabolic pathological conditions. Thus, drugs acting on the renin-angiotensin system [angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers], or on the glucose or lipid metabolism as substrate of oxidative mechanisms (statins and nutraceuticals) in association with a dietary restriction may be taken in account, because they play a synergistic effect in preventing functional and structural changes responsible for the high cardiovascular risk in metabolic syndrome.