Metabolic syndrome medical therapy: Difference between revisions
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==Treatment== | ==Treatment== | ||
* The first line treatment is change of lifestyle (i.e., caloric restriction | * The first line treatment is change of lifestyle (i.e., caloric restriction, physical activity, weight loss). However, drug treatment is frequently required for complications that are seen with them. | ||
===Hypertension=== | |||
* | |||
* | * BP goal- 140/90 or 130/80 in diabetics (JNC 7 guidelines). | ||
**Use of drugs that decrease [[insulin resistance]] e.g., [[metformin]] | * Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) should be preferred over rather diuretics or beta-blockers in these patients. | ||
===Elevated low-density lipoprotein cholesterol (LDL-C)=== | |||
* The goal is to get the LDL down to < 100 mg/dl. | |||
* Statins are drug of choice. | |||
* Statins are however contraindicated in [[pregnancy]]. | |||
===Decreased high-density lipoprotein cholesterol (HDL-C)=== | |||
* Diet (decreased calorie intakes) | |||
* Increased physical activity | |||
* Niacin | |||
* Cholesteryl ester transfer protein (CETP) inhibitors (torcetrapib) and anacetrapib are in trial stages and their benefits in increasing HDL levels are yet to be proved. | |||
===Elevated Triglyceride== | |||
* Fibric acid | |||
* Niacin (however at higher doses (>1500 mg/d) it may exacerbate hyperglycemia) | |||
* Addition of omega-3 fatty acids also produces beneficial effects. | |||
===Diabetes=== | |||
* Use of drugs that decrease [[insulin resistance]] e.g., [[metformin]]. Use of [[thiazolidinedione]]s is controversial and not FDA approved. | |||
===Cardiovascular risk=== | |||
* Aspirin therapy may be helpful in the primary prevention of cardiovascular complications | |||
==See also== | ==See also== | ||
Revision as of 02:31, 29 September 2011
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Metabolic syndrome Microchapters |
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Treatment |
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Metabolic syndrome medical therapy On the Web |
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Risk calculators and risk factors for Metabolic syndrome medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]
Overview
Metabolic syndrome is formed by a constellation of medical disorders that increases one's risk for cardiovascular disease and diabetes. It effects a large number of people in a clustered fashion. Management of metabolic syndrome involves dietary modifications, exercise and drug therapy for the complications (diabetes, stroke, angina, myocardial infarction) found associated with these conditions.
Treatment
- The first line treatment is change of lifestyle (i.e., caloric restriction, physical activity, weight loss). However, drug treatment is frequently required for complications that are seen with them.
Hypertension
- BP goal- 140/90 or 130/80 in diabetics (JNC 7 guidelines).
- Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) should be preferred over rather diuretics or beta-blockers in these patients.
Elevated low-density lipoprotein cholesterol (LDL-C)
- The goal is to get the LDL down to < 100 mg/dl.
- Statins are drug of choice.
- Statins are however contraindicated in pregnancy.
Decreased high-density lipoprotein cholesterol (HDL-C)
- Diet (decreased calorie intakes)
- Increased physical activity
- Niacin
- Cholesteryl ester transfer protein (CETP) inhibitors (torcetrapib) and anacetrapib are in trial stages and their benefits in increasing HDL levels are yet to be proved.
=Elevated Triglyceride
- Fibric acid
- Niacin (however at higher doses (>1500 mg/d) it may exacerbate hyperglycemia)
- Addition of omega-3 fatty acids also produces beneficial effects.
Diabetes
- Use of drugs that decrease insulin resistance e.g., metformin. Use of thiazolidinediones is controversial and not FDA approved.
Cardiovascular risk
- Aspirin therapy may be helpful in the primary prevention of cardiovascular complications