The association of the metabolic syndrome with target organ damage: focus on the heart, brain, and central arteries

ABSTRACT

Introduction

The metabolic syndrome (MetS) is an adverse metabolic state composed of obesity, hyperglycemia/pre-diabetes, hypertension, and dyslipidemia. It substantially increases the risk of type 2 diabetes, cardiovascular disease (CVD) and mortality, and has a huge impact on public health.

Area covered

The present review gives an update on the definition and prevalence of MetS, and its impact on cardiac structure and function as well as on the brain and central arteries. The association with CVD and mortality risk is discussed. Focus is mainly directed toward the subclinical target organ damage related to MetS. Data is also critically reviewed to provide evidence on the incremental prognostic value of overall MetS over its individual components.

Expert commentary

MetS is a clinical risk condition associated with subclinical and clinical CVD and mortality. Roughly, 30% of the world population suffer from MetS. As all components of the MetS are modifiable, optimal preventive and therapeutic measures should be initiated to improve CV risk control, particularly aggressively treating hypertension and hyperglycemia, and encouraging people to adopt healthy lifestyle as early as possible is of great importance.

KEYWORDS:

• Cardiovascular disease
• diabetes mellitus
• dyslipidemia
• hypertension
• metabolic syndrome
• obesity
• mortality

Article highlights

• MetS is an adverse cardiometabolic risk cluster, representing a metabolic state composed of obesity, hypertension, pre-diabetes, and dyslipidemia.

• The prevalence of MetS varies in different populations, but is approximately 30%, and increases with age.

• MetS increases the risk of DM type 2, CVD, and mortality.

• MetS is associated with clinical and subclinical TOD.

• Cardiac changes in MetS are LV hypertrophy or concentric remodeling, preclinical or clinical systolic and/or diastolic dysfunction, fibrosis, ischemia, and impaired myocardial metabolism.

• MetS increases the risk of atrial fibrillation, a major risk factor for ischemic stroke.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in, or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.