Cardiometabolic Syndromes and Associated Cardiovascular Risks: A Narrative Review

BACKGROUND: Cardiovascular risk (CVR) is closely linked to metabolic and endocrine disorders that share common mechanisms such as insulin resistance, adipose tissue dysfunction, low-grade inflammation, and lipid abnormalities. Conditions including metabolic syndrome (MetS), hypertriglyceridemic waist (HTGW), metabolic dysfunction-associated steatotic liver disease (MASLD), cardiorenometabolic (CKM) syndrome, and polycystic ovary syndrome (PCOS) present overlapping yet distinct phenotypes that contribute to vascular injury and cardiometabolic progression. SUMMARY: This review integrates current evidence connecting MetS, HTGW, MASLD, CKM syndrome, and PCOS within a unified cardiometabolic framework. Although each condition has specific diagnostic criteria, they converge pathophysiologically and collectively increase long-term CVR. Understanding these shared pathways may enhance early detection of subclinical disease. Precision medicine strategies incorporating clinical, biochemical, and imaging biomarkers offer the potential for personalised risk stratification and targeted interventions. KEY MESSAGES: MetS, HTGW, MASLD, CKM syndrome, and PCOS share core mechanisms driving cardiometabolic deterioration. MASLD is a major independent predictor of cardiovascular morbidity and mortality. CKM syndrome represents a continuum integrating metabolic, renal, and cardiovascular dysfunction. Early identification of high-risk phenotypes may improve prevention strategies. Precision medicine approaches can refine CV risk assessment and guide personalised management.