Key result
Aggressive management of metabolic syndrome components, particularly with renin-angiotensin system inhibitors, may delay or prevent new-onset diabetes and cardiovascular events.
This review highlights the links between metabolic syndrome and cardiovascular disease, emphasizing the role of insulin resistance and the potential of therapies like ACE inhibitors and ARBs in reducing cardiovascular events and new-onset diabetes.
Supports consideration of RAS inhibitors in metabolic syndrome; leaves open confirmation in prospective outcome trials.
Metabolic syndrome (MetS) has been defined in different ways. However, key components common to most definitions are a constellation of risk factors including abdominal adiposity, impaired fasting glucose, hypertension, and dyslipidemia. A major mediator of MetS appears to be insulin resistance, which relates to the development of the vascular and metabolic dysfunctions that precede overt cardiovascular disease and type 2 diabetes. Evidence suggests that the mechanisms underlying the elevated cardiovascular risk associated with MetS begin with subclinical organ damage. Therapy for MetS targets individual components of the syndrome and includes lifestyle interventions, lipid-modifying therapy, and antihypertensive agents, particularly those that inhibit the renin-angiotensin system. Results of trials of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have demonstrated reductions in new-onset diabetes and cardiovascular events in a wide range of patients. Clinical trials to investigate further the role of these drugs in the primary prevention of type 2 diabetes in patients with MetS are currently under way. The purpose of this paper is to review the MetS from the perspective of the cardiology workforce with the hope that a better understanding of the links between MetS and cardiovascular disease could lead to improved management of persons at risk.
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Cooper‐DeHoff et al. (2007) conducted a review in Metabolic Syndrome and Cardiovascular Disease. Cardiovascular risk factor management (lifestyle, lipid-modifying, and antihypertensive agents) was evaluated. Aggressive management of metabolic syndrome components, particularly with renin-angiotensin system inhibitors, may delay or prevent new-onset diabetes and cardiovascular events.
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