Current Hypertension Reports

, Volume 13, Issue 2, pp 142–148 | Cite as

Metabolic Syndrome and Heart Failure—The Risk, Paradox, and Treatment

  • Krishna K. Gaddam
  • Hector O. Ventura
  • Carl J. Lavie


The constellation of obesity, hypertension, dyslipidemia, and insulin resistance—together referred to as metabolic syndrome (MetS)—is increasing in prevalence in the American population and also worldwide. The individual components of MetS and MetS as a whole increase the risk of heart failure, cardiovascular mortality, and all-cause mortality. Despite this adverse association, numerous studies have documented an obesity paradox, in which overweight and obese people with established cardiovascular disease, including hypertension, coronary heart disease, heart failure, and peripheral arterial disease, have a better prognosis than patients who are not overweight or obese. Current treatment strategies for these patients include weight loss, control of blood pressure and cholesterol levels, and treatment of hyperglycemia. Because of increasing evidence for the obesity paradox, some physicians question whether obesity should be treated when it is associated with heart failure. Several studies have shown improvement in left ventricular function and decreased mortality and morbidity from heart failure with weight loss and treatment of elevated blood pressure, cholesterol, and hyperglycemia. The most reasonable approach at this time appears to be weight loss and exercise, lowering blood pressure to less than 130/80 mm Hg, low-density lipoprotein (LDL) cholesterol to less than 100 mg/dL, and glycosylated hemoglobin levels to less than 7%.


Obesity Hypertension Dyslipidemia Insulin resistance Diabetes mellitus Metabolic syndrome Obesity paradox Heart failure 



No potential conflicts of interest relevant to this article were reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Krishna K. Gaddam
    • 1
  • Hector O. Ventura
    • 2
  • Carl J. Lavie
    • 3
  1. 1.Division of Cardiovascular DiseasesJohn Ochsner Heart and Vascular Institute Ochsner Clinical School - The University of Queensland School of MedicineNew OrleansUSA
  2. 2.Division of Heart Failure and TransplantationJohn Ochsner Heart and Vascular Institute Ochsner Clinical School - The University of Queensland School of MedicineNew OrleansUSA
  3. 3.Cardiac Rehabilitation and Exercise Laboratories, Division of Cardiovascular DiseasesJohn Ochsner Heart and Vascular Institute Ochsner Clinical School - The University of Queensland School of MedicineNew OrleansUSA

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