Practical management of patients with hypertension and metabolic risk factors: Using lifestyle to reduce risk

Clusters of risk factors that develop with aging signify increased cardiovascular risk. The importance of this risk factor burden in those with hypertension is underscored by the fact that only one in seven hypertensive men and one in 20 hypertensive women develop coronary heart disease if no concomitant risk factors are present. This review focuses on the practical management of hypertensive patients with additional metabolic risk factors who can be viewed as having the metabolic syndrome. Important principles of management include regular monitoring; an emphasis on increasing physical activity and better nutrition to help promote weight loss or, at a minimum, lack of weight gain; a focus on long-term rather than short-term results because metabolic fitness is a lifelong endeavor; and, most importantly, assessing at the start the patient's readiness to change and preparedness to change if the patient is suitably motivated. © 2008 Current Medicine Group LLC.