Markolf Hanefeld, Frank Pistrosch, Jan Schulze and Ulrike Rothe
The metabolic syndrome represents a cluster of closely connected premorbid risk factors or diseases with visceral obesity, prediabetes or type 2 diabetes, hypertension and low dyslipidemia as established traits affecting about 20 % of adults in developed countries. This syndrome develops on a common soil with overnutrition, low physical activity and psychosocial stress as major components. Common comorbidities are fatty liver, sleep apnoe and gout with cardiovascular complications, nephropathy and type 2 diabetes as ‘endstage’ diseases. The term metabolic vascular syndrome was proposed to signal premorbid cardiovascular state and increased cardiovascular morbidity. Thus, a rational diagnostic is needed to elucidate the complex cluster of diseases as basis for an integrated therapy. There is a clear priority for life style intervention however most diseases of the metabolic syndrome need medical treatment. Medical treatment of single traits has to take into account possible pleiotropic or adverse effects on the other traits. Here we present the pros and cons of major medical interventions in type 2 diabetes, hypertension, dyslipidemia and hypercoagulation in the context with the metabolic syndrome.
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