Treatment of dyslipidemia to reduce cardiovascular risk in patients with multiple risk factors.

Individuals with metabolic syndrome typically have atherogenic dyslipidemia, characterized by increased concentrations of triglycerides, reduced concentrations of high-density lipoprotein cholesterol, and increased concentrations of small dense low-density lipoprotein particles. Statins have been shown to improve atherogenic dyslipidemia in patients with metabolic syndrome in a number of studies. Fibrates and niacin have also been shown to be effective therapy in these patients. Post hoc analyses suggest that lipid-regulating therapy reduces cardiovascular risk in patients with metabolic syndrome. Other approaches to the treatment of atherogenic dyslipidemia in these patients include targeting insulin resistance and adipose tissue. Agents such as the peroxisome proliferator-activated receptor-gamma agonist pioglitazone and the CB1 receptor antagonist rimonabant improve insulin resistance as well as atherogenic dyslipidemia. Weight loss has also been shown to improve risk factors associated with metabolic syndrome.