Metabolic syndrome in hypertensive patients: An unholy alliance

Table 3 Therapeutic approaches in patients with metabolic syndrome

Metabolic syndrome component	Goal of therapy	Drugs	Diet	Physical exercise
Arterial hypertension	BP < 140/90 mmHg	ACEI or ARBs and/ or Ca-antagonists and/ or alpha-blockers1 Limit diuretics and beta-blockers	Salt restriction and hypocaloric	Regular exercise
Hyperglycemia	HbA1c < 7%-6.5%	Metformin GLP-1-Agonists DPP-4-inhibitors	Hypocaloric	Regular exercise
Obesity	Weight loss 7%-10%	Orlistat Bariatric Surgery	Hypocaloric	Regular exercise
Dyslipidemia	LDL < 100-70 mg/dL TG < 150 mg/dL HDL: Men > 40/ Women > 50 mg/dL	Statins ± ezetimibe. PUFA-n-3, Fibrates	Hypocaloric	Regular exercise

¹Not first choice. BP: Blood pressure; ACEI: Angiotensin converting enzyme inhibithors; ARBs: Angiotensin II receptor blockers; GLP-1: Glucagon-like peptide-1; DPP-4: Dipeptidyl peptidase-4; LDL: Low-density lipoprotein; TG: Triglycerides; HDL: High-density lipoprotein; PUFA-n-3: Omega-3-Polyunsaturated.