Implications of the metabolic syndrome: the new epidemic

On the basis of traditional risk factors, a large number of individuals in the United States can be classified as at intermediate risk for the development of ischemic heart disease. The diagnosis of the metabolic syndrome can help determine whether patients at intermediate risk should be considered for more aggressive risk-factor reduction. The measurement of novel risk factors, such as inflammatory markers, can identify a group of patients at high intermediate risk. The Adult Treatment Panel of the National Cholesterol Education Program suggests considering a more aggressive low-density lipoprotein cholesterol treatment goal in this group of individuals. In addition, the presence of the metabolic syndrome is highly predictive of the development of diabetes mellitus. A treatment strategy focusing on aerobic exercise and weight loss can help delay or prevent the development of diabetes and can help reduce cardiovascular risk. For significant risk reduction to be achieved, treatment strategies must focus on therapy for all risk factors, including dyslipidemia, hypertension, and insulin resistance.