- MetS is defined by a constellation of an interconnected physiological, biochemical, clinical, and metabolic factors that directly increases the risk of atherosclerotic cardiovascular disease (ASCVD), (T2DM), and all cause mortality
- The collection of unhealthy body measurements and abnormal laboratory test results include atherogenic dyslipidemia, hypertension, glucose intolerance, proinflammatory state, and a prothrombotic state
Treatment
ACEi or ARB
- should be the first-line classes of agents in the MetS, especially in the setting of diabetes or CKD
- ARBs may be used in those who cannot tolerate ACE inhibitors or as an alternative to ACE inhibitors in people who have a left ventricular dysfunction
- shown to be effective in reducing the incidence of albuminuria or progression of nephropathy in patients with diabetes
- reduces the rate of new-onset diabetes as compared with the use of diuretic and/or β-blockers
Calcium Channel Blockers
- Recommended by ESH/ESC as does not worsen insulin sensitivity
Beta Blockers and Diuretics
- associated with an increased risk for diabetes
- although diuretics/beta blockers do in fact lower the risk for cardiovascular events
- Most investigators in the hypertension field believe that the potential benefit of low-dose diuretics in combination antihypertensive therapy outweighs their risk
Metabolic Syndrome: Risk Factors and Recommendations - http://www.uspharmacist.com/content/d/feature/c/46619/#sthash.JTviYKDC.dpuf
References:
- ESH/ESC Hypertension Guidelines: Hypertension Treatment for People With Metabolic Syndrome. http://www.ccmdweb.org/dsl/middle.aspx?Slideid=3361&Catid=1035
- A Comprehensive Review on Metabolic Syndrome. http://www.hindawi.com/journals/crp/2014/943162/
- Metabolic Syndrome: Risk Factors and Recommendations http://www.uspharmacist.com/content/d/feature/c/46619/#sthash.JTviYKDC.dpuf
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