Metabolic syndrome and role of ACE inhibitors in its management: focus on trandolapril

Abstract

The review describes modern view in metabolic syndrome, diagnostic criteria and management. ACE inhibitors are shown to be indicated to such patients. Trandolapril due to its significant advantages - long duration of action, dual elimination and high tissue activity can be considered predominantly indicated to patients with metabolic syndrome.

Metabolic Syndrome and Its Manifestations

“…Russian experts on the diagnosis and treatment of MS in the recommendations of the Consensus of Russian Experts on the problem of MS in the Russian Federation in 2010 suggested that when considering the possibilities of diagnosing MS, the main feature should be taken into account-central android obesity, in which the OT in women was more than 80 cm, and in men-more than 94 cm, and additional criteria: an increase in the level of TG more than 1.7 mmol/l, low-density lipoprotein cholesterol(LDL) more than 3 mmol/L, a decrease in the concentrationof LDL LDLcholesterol less than 1 mmol/l in in men and less than 1.2 mmol/ l in women, the presence of fasting hyperglycemia with a plasma glucose level of more than 6.1 mmol/l, impaired glucose tolerance with a plasma glucose level of more than 7.8 and less than 11.1 mmol/l 2 hours after taking carbohydrates.1 Blood pressure should be 130 and 80 mm Hg and/or more. Thus, in accordance with Russian recommendations, MS can be diagnosed in the presence of the main trait in combination with two additional criteria, while the mandatory presence of A G is practically not taken into account.We believe that this is incorrect, and suggest that we talk about the presence of hypertension in a MS patientin combination with signs of impaired both lipid and carbohydrate metabolism [6]. This suggestion is based on our observations, which showed a significant increase in OT in the absence of any deviations in the parameters of lipid and carbohydrate metabolism.…”

“…Almost all Uzbekistan and international conferences, congresses, and congresses pay great attention to this topic, but there is still a paradox: in practical conditions, MS is not diagnosed and, consequently, patients do not receive adequate pathogenetic therapy. The purpose of this article is to present our ideas on this problem and attract the attention of colleagues involved in it, as well as practitioners, to discuss unclear issues both in the field of terminology, understanding the causes and mechanisms of MS development, and in the diagnosis and treatment of MS [1][2][3][4][5][6]. Let's start with the terminology.…”

“…Among them were "metabolic tri syndrome", "polymetabolic syndrome"," abundance syndrome "(N. Mehnert and N.," hormonal metabolic syndrome " and"metabolic vascular syndrome". In 1989, N. coined the term "fatal quartt", which includes hyperlipidemia,as well as impaired carbohydrate tolerance and insulin resistance [6]. The most accepted term for this phenomenon at present is the term "metabolic syndrome", proposed in 1981 by M. Hanefeld, W. Leonardt, although the founder of the theory of MS is considered to be the American scientist G. Reaven, who singled out insulin resistance among the observed metabolic disorders.…”

“…The most accepted term for this phenomenon at present is the term "metabolic syndrome", proposed in 1981 by M. Hanefeld, W. Leonardt, although the founder of the theory of MS is considered to be the American scientist G. Reaven, who singled out insulin resistance among the observed metabolic disorders. his Buntigton lecture, delivered in 1988, went down in the history of medicine as "the birth of MS" [1][2][3][4][5][6]. Since then, the recommendations of various expert commissions on MS (WHO, 1998; US National Committee on Cholesterol, 2001; International Diabetes Federation, 2005) often suggest diagnostic criteria that differ slightly from each other.…”

“…Currently, there is a general understanding of modern MS diagnostic capabilities. The WHO recommendations (2001) are quite specific and easy to apply [6]. Russian experts on the diagnosis and treatment of MS in the recommendations of the Consensus of Russian Experts on the problem of MS in the Russian Federation in 2010 suggested that when considering the possibilities of diagnosing MS, the main feature should be taken into account-central android obesity, in which the OT in women was more than 80 cm, and in men-more than 94 cm, and additional criteria: an increase in the level of TG more than 1.7 mmol/l, low-density lipoprotein cholesterol(LDL) more than 3 mmol/L, a decrease in the concentrationof LDL LDLcholesterol less than 1 mmol/l in in men and less than 1.2 mmol/ l in women, the presence of fasting hyperglycemia with a plasma glucose level of more than 6.1 mmol/l, impaired glucose tolerance with a plasma glucose level of more than 7.8 and less than 11.1 mmol/l 2 hours after taking carbohydrates.1 Blood pressure should be 130 and 80 mm Hg and/or more.…”