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Lifestyle modifications for the prevention and treatment of cardiovascular disease: an evidence-based approach.

Two conditions contributing to cardiovascular disease (CVD) are hypertension and diabetes mellitus. Multiple metabolic components contribute to hypertension. These same metabolic and hemodynamic abnormalities play a vital role in type 2 diabetes mellitus, which is often accompanied by the metabolic syndrome. Metabolic syndrome includes elevated blood pressure, increased triglycerides, decreased high-density lipoprotein (HDL)-cholesterol, and central obesity. Additional features are the prothrombotic state, endothelial dysfunction, and markers for inflammation. Insulin resistance is central to the metabolic syndrome. Through a meta-analysis of multiple studies, an assessment of various life-style modifications to reduce CVD is discussed with recommendations on their validity and value.