Managing Cardiometabolic Risk

Numerous clinical trials have shown the benefits of treating traditional risk factors to ward off cardiovascular events. For example, a wealth of lipid lowering trials have demonstrated that lowering LDL cholesterol concentrations with statins reduces the risk of first or recurrent cardiovascular events. However, statin trials that have been able to study subgroups of abdominally obese patients with features of the metabolic syndrome have generally shown the following:

1. Patients in statin trials with the metabolic syndrome are more likely to develop cardiovascular complications than patients without the metabolic syndrome.
2. Despite the fact that patients with the metabolic syndrome benefit from statin therapy, they are nevertheless at higher residual risk of cardiovascular disease (CVD) than statin-treated patients who do not have features of the metabolic syndrome.

These results suggest that CVD risk can be further reduced if abdominal obesity/metabolic syndrome are targeted along with traditional risk factors. Morbidity and mortality trials will be required to test this hypothesis.