Review article
Drug Therapy of the Metabolic Syndrome
Ivana Pavlić-Renar
Abstract
The goal in the treatment of metabolic
syndrome is the prevention of circulatory diseases, and
in particular of major vascular events. The additional goal
in patients with early-stage glucose tolerance impairment
is the preservation of glucose metabolism. The studies
of lifestyle changes, troglitazone, metformin, acarbose
and orlistat have shown their effi cacy in the prevention
of diabetes. However, no medication can be currently
recommended for this purpose.
As thiazolidinediones with their numerous nonhypoglycemic
effects are particularly interesting in the treatment of metabolic
syndrome, numerous prospective studies are underway.
Statins have proven to be effi cient in the prevention
of major vascular events, more than expected from a mere
reduction of cholesterol levels, and especially in high-risk
individuals.
The correction of hypertension in metabolic syndrome
requires special attention. Blood pressure target should be
as low as possible, with a careful drug choice. The inhibitors
of renin–angiotensin–aldosterone system (RAAS) represent
the drugs of fi rst choice. However, most patients need
multiple medications. Diuretics, nondihydropyridine calcium
channel blockers and additional drugs might be added while
observing usual contraindications and interactions.
The conclusion is that in addition to basic treatment, i.e.
lifestyle changes, the choice of drugs for the correction of
metabolic syndrome components is especially important.
Priority is given to drugs with favourable or at least neutral
metabolic effect. Drugs that might correct the central
defect - overactive visceral fat tissue - are particularly interesting
for prospective studies.
Keywords
metabolic syndrome; hypertension; visceral fat; drugs
Hrčak ID:
19002
URI
Publication date:
15.11.2004.
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