1. Take the Metabolic Syndrome Quiz
2. Type 2 Diabetes: Learn the Warning Signs
3. A Visual Guide to Heart Disease

Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

View Full Profile

Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

View Full Profile

In this Article

• What is metabolic syndrome?
• How is metabolic syndrome defined?
• How common is metabolic syndrome?
• What causes, and what are the risk factors and symptoms of metabolic syndrome?
• Why should I know about metabolic syndrome?
• What is the treatment for metabolic syndrome?
• Diet and metabolic syndrome
• Exercise and metabolic syndrome
• Cosmetic surgery to remove fat
• What if lifestyle changes are not enough to treat metabolic syndrome?
• Summary
• Metabolic Syndrome FAQs
• Patient Comments: Metabolic Syndrome - Symptoms
• Patient Comments: Metabolic Syndrome - Effective Treatments
• Find a local Internist in your town
• Metabolic Syndrome Index

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.