METABOLIC DISORDERS AND CARDIOVASCULAR RISK: AN INTERNAL MEDICINE PERSPECTIVE

Metabolic disorders—including obesity, insulin resistance, dyslipidemia, and hypertension—pose a significant global health challenge due to their strong and multifactorial association with cardiovascular disease (CVD). This review explores the pathophysiological mechanisms linking these metabolic abnormalities to cardiovascular outcomes, with a particular focus on implications for internal medicine. Metabolic syndrome, characterized by a clustering of cardiovascular risk factors, amplifies the progression of atherosclerosis and end-organ damage through inflammatory, hormonal, and hemodynamic pathways. Central to this is insulin resistance, which drives dyslipidemia, endothelial dysfunction, and sympathetic overactivity, all contributing to vascular injury and remodeling. The review synthesizes evidence from major epidemiological studies and clinical trials, including the Framingham Heart Study, REDUCE-IT, EMPA-REG OUTCOME, and LEADER, highlighting how advances in pharmacotherapy—such as SGLT2 inhibitors and GLP-1 receptor agonists—offer cardiovascular benefits beyond glucose control. Additionally, the role of novel biomarkers and imaging modalities in enhancing risk stratification is discussed. Internal medicine plays a pivotal role in early identification, integrated care, and patient-centered management of individuals with metabolic risk. Equally important are the public health and health equity dimensions, as underserved populations face a disproportionate burden of metabolic and cardiovascular diseases. This paper underscores the urgency of comprehensive, multidisciplinary interventions and advocates for a precision medicine approach to reduce long-term cardiovascular morbidity and mortality among metabolically at-risk individuals.