Ivan Tkáč
At least one fourth of population of developed countries is afflicted by metabolic syndrome that is a high risk for type 2 DM and atherosclerosis development. Present therapeutic interventions have been focused primarily on particular manifestations of metabolic syndrome like treatment of dyslipidemia, hypertension, obesity and type 2 diabetes mellitus. These therapeutic approaches, mostly aggressive treatment of dyslipidemia and hypertension, are highly beneficial in prevention of cardiovascular diseases in patients with metabolic syndrome. More and more emphasis has been given on prevention of type 2 diabetes mellitus in patients with glucose tolerance disorder. This approach can postpone the onset of long term hypoglycemia as an independent risk factor of atherosclerosis. Clinical studies proved that interventions which are able to prevent development of type 2 diabetes mellitus, like therapy with metformin or inhibitors of the renin-angiotensin system, are effective in prevention of atherosclerosis. A new approach in metabolic syndrome is therapy focused on insulin resistance lowering that can affect several symptoms. The effect has been confirmed in several drug groups, like glitazones, glitazars and rimonabant. Results of further clinical randomized studies can reveal effectiveness of insulin resistance lowering on effective prevention of cardiovascular diseases.