Metabolic syndrome. Diagnosis and clinical management, an official document of the Working Group of the Italian Society of Cardiovascular Prevention (SIPREC)

Metabolic syndrome (MS) is a complex clinical condition, characterised by a constellation of different metabolic and cardiovascular traits, typically high blood pressure, abdominal obesity, lipid profile abnormalities, insulin resistance and glucose intolerance. More recently, other features have been proposed; in particular, chronic proinflammatory and prothrombotic states seem to further characterise MS. Because of its multifactorial pathogenesis, a singular definition of this clinical condition is still debated, and physicians tend to make individual choices, e.g. the threshold for treatment initiation is heterogeneous. The lack of specific international guidelines, consisting of a diagnostic and therapeutic algorithm with an accurate cardiovascular risk stratification, makes the clinical management of patients with MS by primary physicians difficult and non-uniform. In particular, while there is convincing evidence that the progressive addition of components of MS increase cardiovascular risk, there are no consistent indications regarding treatment priorities and strategies. The Italian Society for Cardiovascular Prevention (Società Italiana di Prevenzione Cardiovascolare) [SIPREC], in the form of a panel of expert scientists operating in different areas of medicine, has compiled this consensus document in order to create a balanced and qualified document on the diagnosis and clinical management of MS. This document is focused on global risk-based stratification, aimed at identifying ‘low-risk’ and ‘high-risk’ patients within those presenting with MS. This approach may be particularly effective in clinical practice in identifying patients with MS with different degrees of cardiovascular disease risk profile. This approach may also be helpful to develop therapeutic strategies based on the global cardiovascular risk profile.