ABSTRACT
The termmetabolic syndrome refers to a common pattern of multiple risk factors facilitating the development of cardiovascular (CV) disease and type 2 diabetes that has emerged recently, and is largely but not completely driven by obesity (1). An adequate stratification of global CV risk must then contemplate the presence of traditional CV risk factors and emerging markers found in individuals with excess intra-abdominal adiposity and a “dysfunctional” adipose tissue phenotype. This global risk is defined as cardiometabolic risk (2) and is particularly elevated in the hypertensive population (3-4). More than two-thirds of the hypertensive population present with overweight and obesity, and 40% to 60% can be classified as having metabolic syndrome according to ATP III criteria (3-4). On the other hand, arterial hypertension is number one killer in the general population in developed as well as in developing countries, as is demonstrated in recently published data from WHO (5), and the association of elevated blood pressure and diabetes is the most devastating for the CV and the renal systems (6). The need to consider cardiometabolic risk in the risk stratification of hypertensive patients as well as the need to consider its treatment is nowadays totally required. In fact, this situation has forced the recognition by the Guidelines of the European Society of Hypertension and European Society of Cardiology (7) of metabolic syndrome as a situation of high added risk as soon as BP is above 130 and/or 85 mmHg (high-normal BP and above) (Fig. 1).
