Metabolic syndrome: perception or reality?

Metabolic syndrome is associated with increased risk for type 2 diabetes and cardiovascular disease. It has garnered considerable clinical and research interest as a potential target to reduce cardiovascular risk in addition to the classical risk factors. Whether it exists as a distinct clinical entity has become a subject of controversy and debate. This review appraises the evidence in support of or against recognizing metabolic syndrome as a clinical condition that requires therapeutic intervention. Proper evaluation of cardiovascular disease risk should start with consideration of traditional risk factors using validated tools, such as the short-term 10-year Framingham risk score. Individuals with abdominal obesity should be further assessed for associated cardiometabolic risks. Global cardiovascular disease risk should take into consideration not only short-term but also lifetime risks.