Targeting dyslipidemia in the metabolic syndrome: an update.

Background: The management of the Metabolic Syndrome (MetS) includes lifestyle interventions (e.g. diet and exercise for weight reduction), as well as drug treatment to normalize blood pressure, high-density lipoprotein cholesterol, triglycerides and glucose values. Treatment of atherogenic dyslipidemia should comprise a primary therapeutic target since it is associated with an increased risk of cardiovascular disease.

Objective: To review the efficacy of the drugs available for the management of the dyslipidemia associated with MetS.

Methods: MEDLINE was searched up to May 10, 2009 for studies in English using the mesh-terms "metabolic syndrome", "hypercholesterolemia", "dyslipidemia", "treatment", "statins" and "cardiovascular disease" in various combinations to identify treatment strategies for the management of the dyslipidemia of the MetS.

Results/conclusions: Several drugs have been described for the management of the dyslipidemia of the MetS, namely statins, fibrates, ezetimibe, niacin, bile acid sequestrants, cholesteryl ester transfer protein inhibitors, as well as combined treatment regimes. Although each of these may deal to some extent with some aspect of the dyslipidemia of the MetS compared with placebo, a direct comparison of all these agents has not been carried out. A head-to-head comparison between the suggested regimes could identify the mono- or combination therapy for the optimal management of dyslipidemia associated with MetS.