The NCEP guidelines give priority to treating the root causes of the metabolic syndrome that are susceptible to change — namely, excessive weight and physical inactivity. (Genetic factors that contribute to the syndrome cannot be reversed.) Lifestyle measures such as diet control and exercising can often reduce insulin resistance and other conditions associated with the syndrome. In some cases drug treatment of spe-cific conditions is recommended to reduce the risk of heart disease. The guidelines accordingly advise treating abnormal blood levels of lipids with lipid-altering drugs, high blood pressure with antihypertensive drugs, and blood clotting with aspirin. Although there exist blood-glucose-lowering drugs, including metformin, rosiglitazone, and pioglitazone, that are known to reduce insulin resistance, the NCEP guidelines note that it has not yet been definitely proved that they can reduce heart disease.
