Managing cardiometabolic risk: an evolving approach to patient care

Cardiometabolic risk encompasses a cluster of risk factors that may predispose individuals to cardiovascular disease and type 2 diabetes. These risk factors, some of which are currently undermanaged in clinical practice, involve multiple pathways and physiologic systems and point to a need for a comprehensive management approach. Abdominal obesity is a key component of cardiometabolic risk, increasing the incidence of insulin resistance, vascular inflammation, dyslipidemia, and hypertension. Adipose tissue, now recognized as an endocrine organ, and its hormonal products appear to play a significant role in the regulation of fat and glucose metabolism throughout the body. These mechanisms are clearly involved in the development of cardiovascular and metabolic disease. Current treatment protocols generally involve a fragmented approach to care, advocating management of only the clinically evident conditions. As cardiometabolic risk factors tend to cluster, patients often have additional subclinical conditions that would be discovered through comprehensive evaluation for the entire constellation of risk factors, thereby enabling clinicians to recommend optimal treatment to prevent cardiovascular and metabolic morbidities.