Metabolic syndrome and diabetes mellitus are as much vascular conditions as they are metabolic disorders. It is now well established that a majority (as high as 80%) of diabetic patients die of cardiovascular complications. Current evidence also suggest that, on average, diabetic patients have evidence of insulin resistance for approximately 5 to 6 years before the onset of clinical hyperglycemia. This prediabetic state can manifest itself as metabolic syndrome, which is a constellation of several cardiovascular risk factors including obesity (especially truncal), hypertension, dyslipidemia, glycemic abnormalities, and other metabolic perturbations, which are caused primarily by insulin resistance (1,2). The final products of this syndrome, affecting the cardiovascular system, are endothelial dysfunction, atherosclerosis, and cardiovascular disease (Fig. 1) (3).