Cardiovascular risk: prevention and treatment of the metabolic syndrome.

The metabolic syndrome is a cluster of metabolic abnormalities, including impaired glucose metabolism, hypertension, dyslipidemia and abdominal obesity. It is a precursor to type 2 diabetes and a powerful independent risk factor for cardiovascular disease. Lifestyle changes, such as a diet high in saturated fats and a lack of physical exercise, have contributed to a worldwide increase in the prevalence of the metabolic syndrome and its associated complications. Identification and effective management of patients with the metabolic syndrome is important to reduce their risk of subsequent disease. Lifestyle modifications are an essential first step, and lipid-lowering therapy may also be required to achieve the lipid goals set out in current treatment guidelines. Statins are the most effective class of lipid-lowering drugs. Recent studies in patients with type 2 diabetes or the metabolic syndrome have shown that rosuvastatin was more effective than atorvastatin, simvastatin or pravastatin in reducing low-density lipoprotein cholesterol and enabling patients to reach lipid goals.