Metabolic syndrome is thought to be present in nearly half of the adult population of the US and one-quarter of adults in the UK. It is associated with obesity and an atherogenic lipid profile, and is strongly implicated in coronary heart disease. Various bodies have provided diagnostic criteria for metabolic syndrome and guidelines for its treatment. The lack of a single, integrated, evidence-based guideline led a group of UK experts to propose a set of practical recommendations that can be used to guide clinical management of this important syndrome. Metabolic syndrome is a multifaceted condition with a significant role in the pathogenesis of coronary heart disease (CHD). The Expert Panel of the US National Cholesterol Education Program (NCEP) highlighted management of metabolic syndrome as imperative in the battle to reduce mor- tality from CHD 1 . According to the NCEP, targeting this syndrome is second in importance only to reduction of low- density-lipoprotein cholesterol (LDL-C) in lowering cardio- vascular risk. In 2004, a group of UK experts met to discuss current evidence and create a consensus guideline 2 .