Preclinical Atherosclerosis, Metabolic Syndrome and Risk of Cardiovascular Events

The CVD represent nowadays the first cause of mortality and disability in western country. But atherosclerosis disease is a gradually process that develops over decades, giving the time to carry out prevention and intervention strategy. Great attention should be made on the analysis of RF and on their correction, especially when they are clustered in a manner that enhances them. For this reason, it’s important to prevent the development of MetS abnormalities (for example with daily physical activity and Mediterranean diet) and to detect it early so as start pharmacological treatment of modifiable risk factors. Moreover, in order to address the therapeutic efforts to the subjects that can receive greater benefit, it is important to have tool to identify subjects affected but non symptomatic yet. For this purpose, non-invasive techniques capable of evaluating arterial wall and endothelial function should enter in routinely evaluation of cardiovascular risk. In particular, according to ESC guidelines (1), carotid ultrasonography, brachial-ankle index measurement and computed tomography for coronary calcium assessment should be taken in mind for further risk stratification of asymptomatic adults at moderate risk. The detection of subclinical lesions indicates the need of a more aggressive management of risk factors, possibly with the help of drug treatment.