Lipid treatment strategies for metabolic syndrome in established cardiovascular disease: A cosensus guideline

Abstract

In is paper we present an evidence-based guideline for the management of metabolic syndrome in patients with established cardiovascular disease. We initially discuss the relationship between the various components of metabolic syndrome and dyslipidaemia, the evidence base for treatment of both LDL and HDL cholesterol and the specific issue of extremely high rates of cardiovascular disease in the Indo-Asian community in the UK. Afthough several national and international guidelines provide treatment strategies for prevention of cardiovascular disease, none provide separate guidance on the prevention and management of coronary heart disease in the context of metabolic syndrome. In this document we emphasise that although statins will remain the mainstay of therapy, there remain a range of additional treatment options to further improve the lipid profile. These include the cholesterol absorption inhibitor, ezetimibe, fibrates and nicotinic acid derivatives. We present an algorithm to guide health professionals treating patients with cardiovascular disease and metabolic syndrome from lifestyle modification through to pharmacotherapy. We hope this will provide a practical, accessible tool for managing the increased cardiovascular risk in patients with metabolic syndrome and established cardiovascular disease. Copyright © 2006 John Wiley & Sons, Ltd.