ABSTRACT
The metabolic syndrome is a clustering of risk factors known to promote or increase the risk of development of cardiovascular disease (CVD). Recent estimates show that approximately one-third of the adult population of developed countries are characterized by metabolic syndrome, by different definitions. The metabolic syndrome, even in the absence of diabetes, is associated with an increased risk of CVD and total mortality, and is related to an increased risk of the development of diabetes. Those with diabetes are considered a cardiovascular risk equivalent and warrant aggressive management of underlying risk factors to optimize prevention of CVD. Initial evaluation of coronary artery disease risk involves global risk estimation using Framingham or other algorithms for risk prediction. The UKPDS risk engine is suitable for use in subjects with preexisting diabetes. Further, consideration of screening for novel risk factors such as C-reactive protein, as well as subclinical atherosclerosis (from carotid ultrasound, computed tomography, or ankle-brachial index), can further refine the estimation of future CVD risk. The presence of subclinical atherosclerosis or elevated levels of C-reactive protein can potentially modify recommended treatment goals for lipid and other cardiovascular risk factors.
