TABLE 8.
Therapy of MetS risk factors
| Therapeutic target | Goals and recommendations |
|---|---|
| Abdominal obesity | 5–10% Weight loss or weight maintenance |
| Lifestyle modification with diet and increased physical activity | |
| Pharmacological weight loss therapy | |
| Bariatric surgery | |
| Insulin resistance/hyperglycemia | Prevention or delay of progression to type 2 diabetes |
| Lifestyle modification and weight loss as described above | |
| Pharmacotherapy | |
| Treatment of diabetes | |
| Appropriate glycemic control | |
| Metabolic dyslipidemia | |
| Primary target: LDL-C | LDL-C lowering as per NCEP:ATPIII goals (see Table 9) |
| Secondary target: non-HDL-C | If TG ≥200 mg/dl, lower non-HDL-C to <30 mg/dl plus the LDL-C goal |
| Tertiary target: HDL-C | If HDL-C <40 mg/dl in men or <50 mg/dl in women, consider therapy for HDL-C raising |
| Elevated blood pressure | Goal BP is <140/90 mm Hg (<130/80 mm Hg if diabetes or CKD present) |
| Prothrombotic state | Consider low-dose aspirin for high-risk patients |
| Proinflammatory state | No specific goals; treat all of the above risk factors |
TG, Triglycerides; BP, blood pressure.