Metabolic syndrome: Therapeutic considerations

Research output: Chapter in Book/Report/Conference proceedingChapter

35 Scopus citations

Abstract

The metabolic syndrome is a constellation of metabolic risk factors for atherosclerotic cardiovascular disease (ASCVD) occurring in one individual. There are five cardiovascular risk factors that accompany the metabolic syndrome: atherogenic dyslipidemia [elevated apolipoprotein B (apo B), elevated triglyceride, small low-density lipoprotein (LDL) particles, and low high-density lipoprotein (HDL)cholesterol], elevated blood pressure, elevated glucose, a prothrombotic state, and a proinflammatory state. The likelihood of an individual developing metabolic syndrome is enhance by underlying risk factors, notably, obesity, insulin resistance, lack of physical activity, advancing age, and hormonal factors (e.g., androgens and corticosteroids). Besides being at higher risk for ASCVD, persons with the metabolic syndrome are at increased risk for type 2 diabetes. Persons with the metabolic syndrome deserve management in the clinical setting to reduce the risk for both ASCVD and type 2 diabetes. The two major therapeutic strategies for treatment of affected persons are modification of the underlying risk factors and separate drug treatment of the particular metabolic risk factors when appropriate. First-line therapy for underlying risk factors is therapeutic lifestyle changes, i.e., weight loss in obese persons, increased physical activity, and anti-atherogenic diet. These changes will improve all of the metabolic risk factors. Whether use of drugs to reduce insulin resistance is effective, safe, and cost-effective before the onset of diabetes awaits the results of more clinical research. Turning to individual risk components, for atherogenic dyslipidemia, drug therapies that promote lowering of apo B and raise HDL cholesterol will be needed for higher risk patients. Treatment of categorical hypertension with drugs has become standard practice. When hyperglycemia reaches the diabetic level, glucose-lowering agents will become necessary when dietary control is no longer effective, and reduction of a prothrombotic state with low-dose aspirin may be indicated in higher-risk patients.

Original languageEnglish (US)
Title of host publicationAtherosclerosis
Subtitle of host publicationDiet and Drugs
EditorsArnold von Eckardstein
Pages107-133
Number of pages27
DOIs
StatePublished - Dec 1 2005

Publication series

NameHandbook of Experimental Pharmacology
Volume170
ISSN (Print)0171-2004
ISSN (Electronic)1865-0325

Keywords

  • Atherogenic dyslipidemia
  • Hyperglycemia
  • Hypertension
  • Insulin resistance
  • Metabolic syndrome
  • Pharmacology therapy
  • Proinflammatory state
  • Prothrombotic state
  • Therapeutic lifestyle changes

ASJC Scopus subject areas

  • Biochemistry
  • Pharmacology, Toxicology and Pharmaceutics(all)

Fingerprint Dive into the research topics of 'Metabolic syndrome: Therapeutic considerations'. Together they form a unique fingerprint.

  • Cite this

    Grundy, S. M. (2005). Metabolic syndrome: Therapeutic considerations. In A. V. Eckardstein (Ed.), Atherosclerosis: Diet and Drugs (pp. 107-133). (Handbook of Experimental Pharmacology; Vol. 170). https://doi.org/10.1007/3-540-27661-0-3