A changing paradigm for prevention of cardiovascular disease: emergence of the metabolic syndrome as a multiplex risk factor

The traditional major risk factors for cardiovascular disease (CVD) are cigarette smoking, hypertension, elevated serum cholesterol, and hyperglycaemia (diabetes). The majority of patients with CVD have multiple risk factors. In recent years a common pattern of multiple risk factors has emerged. This is the metabolic syndrome, which is driven largely by obesity. The metabolic syndrome is particularly important because it is a multiplex risk factor for both CVD and Type 2 diabetes. Although obesity is the primary cause of the metabolic syndrome, there are other endogenous and exogenous factors.