Hypertension and metabolic syndrome in the elderly

The metabolic syndrome, characterized by the association of glucose intolerance, lipid abnormalities, visceral adiposity, and hypertension, has been described many years ago, but its diagnostic criteria have been defined recently. The prevalence of the metabolic syndrome in the general population is relevant, and it increases with aging. Although the pathogenetic mechanisms underlying the metabolic syndrome are still partly unknown, all its components are associated with insulin resistance. The reduction of visceral fat mass reduces insulin resistance and, consequently, it has positive effects on all the components of the metabolic syndrome. In patients with the metabolic syndrome, the pharmacologic treatment of hypertension can affect (either positively or negatively) insulin sensitivity and therefore the other components of the syndrome; on the other hand, in these patients insulin sensitizing agents can show some positive effect on blood pressure.