Metabolic Syndrome (cont.)

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What if lifestyle changes are not enough to treat metabolic syndrome?

What if changes in lifestyle do not do the trick, what then? Drugs to control cholesterol levels, lipids, and high blood pressure may be considered.

If someone has already had a heart attack, their LDL ("bad") cholesterol should be reduced below 70mg/dl. A person who has diabetes has a heart attack risk equivalent to that of someone who has already one and so should be treated in the same way. If you have metabolic syndrome, a detailed discussion about lipid therapy is needed between you and your doctor, as each individual is unique.

Blood pressure goals are generally set lower than 130/80. Some blood pressure medications offer more benefits than simply lowering blood pressure. For example, a class of blood pressure drugs called ACE inhibitors has been found to also reduce the levels of insulin resistance and actually deter the development of type 2 diabetes. This is an important consideration when discussing the choice blood pressure drugs in the metabolic syndrome.

The discovery that a drug prescribed for one condition, and has other beneficial effects is not new. Drugs used to treat high blood sugar and insulin resistance may have beneficial effects on blood pressure and cholesterol profiles. A class of drugs called thiazolidinediones (pioglitazone [Actos] and rosiglitazone [Avandia]) also reduce the thickness of the walls of the carotid arteries; although restrictions have been placed by the US FDA on the use of rosiglitazone (Avandia) due to a reported increase in heart attack and other cardiovascular events in patients taking this drug.

Metformin (Glucophage), usually used to treat type 2 diabetes, also has been found to help prevent the onset of diabetes in people with metabolic syndrome. However, there are currently no established guidelines on treating metabolic syndrome patients with metformin if they do not have overt diabetes.

Medically Reviewed by a Doctor on 6/21/2012

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