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The diagnosis of the metabolic syndrome relies on satisfying the criteria listed in Table 118-1. Screening for associated conditions should be undertaken.

Treatment: Metabolic Syndrome

Obesity is the driving force behind the metabolic syndrome. Thus, weight reduction is the primary approach to this disorder. In general, recommendations for weight loss include a combination of caloric restriction, increased physical activity, and behavior modification. Weight loss drugs or bariatric surgery are adjuncts that may be considered for obesity management (Chap. 172. Obesity). Hypertension (Chap. 117. Hypertension), impaired fasting glucose or diabetes (Chap. 173. Diabetes Mellitus), and lipid abnormalities (Chap. 178. Hypercholesterolemia and Hypertriglyceridemia) should be managed according to current guidelines. The antihypertensive regimen should include an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker when possible.

For a more detailed discussion, see Eckel RH: The Metabolic Syndrome, Chap. 422, p. 2449, in HPIM-19.

Outline

Section 8. Cardiology