Mikuláš Szakács, Jarmila Harvanová
The term “metabolic syndrome” refers to an apparent clustering of several findings in patients: abdominal obesity, insulin resistance, hypertension, and atherogenic dyslipidemia. Subjects with metabolic syndrome are in an increased risk for the development of cardiovascular disease as well as an increased total cardiovascular mortality. Hypertension in coherence with metabolic syndrome is the most important modifiable risk factor of coronary heart disease, stroke, congestive heart failure, end-stage renal disease and peripheral vascular disease. At the same time there is extensive evidence that blood pressure (BP) lowering is a highly effective means of reducing these risks. Therefore, health care professionals must not only identify and treat patients with hypertension but also promote a healthy lifestyle and preventive strategies to decrease the prevalence of hypertension in the general population. Because the risk to an individual patient may correlate with the severity of hypertension, a classification system is essential for decisions making regarding aggressiveness of treatment or therapeutic interventions. Prospective randomized trials have shown a similar outcome with older drugs compared with the newer antihypertensive agents. Blockade of the renin-angiotensin system is considered highly desirable, preferably using angiotensin receptor blockers. However, the ultimate message must be that it is the level of BP attained that has the greatest bearing on outcomes. The means needed to achieve those levels are undoubtedly less important.