Sufficient Weight Reduction Decreases Cardiovascular Complications in Diabetic Patients with the Metabolic Syndrome

摘要

Background:The metabolic syndrome is associated with an increased risk of cardiovascular complications. Especially patients with evident cardiac pathology are at high risk for further complications. A sufficient weight reduction would improve the metabolic pathology and reduce the cardiovascular risk. Unfortunately, overweight and obese patients, even with complicated coronary heart disease, do not alter lifestyles regarding fat intake and physical activity, and in a quarter of these patients body weight increases in the follow-up period. Nonetheless, these patients need a weight reduction to be protected from further cardiovascular complications. Therefore, in overweight patients with insulin resistance in whom lifestyle recommendations have failed, orlistat has been used as an adjunct to decrease significantly overweight and to improve the metabolic pathology without increasing mortality. In our opinion, orlistat could also be an adjunct to lifestyle changes in adipose, diabetic patients with the metabolic syndrome and established heart pathology and signs of incipient cardiac dysfunction.