The metabolic syndrome (MetS) is characterized by a cluster of risk factors 
including central obesity, hypertension, dyslipidemia and insulin resistance, 
The MetS is associated with an increased risk for cardiovascular disease (CVD) 
and type 2 diabetes mellitus (T2DM). Several international organizations have 
defined MetS using different diagnostic criteria that produced discrepancies in 
the results of previous studies, thus leading to the latest Joint Interim 
Societies (JIS) MetS definition. Other risk factors than the diagnostic criteria 
that have been associated with MetS include lipid abnormalities, uric acid, 
liver function, prothrombotic factors, cytokines, adipokines, vitamin D, 
arterial stiffness, polycystic ovary syndrome and obstructive sleep apnea. Apart 
from CVD and T2DM, MetS has been related to non-cardiac vascular diseases and in 
particular to stroke, carotid artery disease, peripheral artery disease, chronic 
kidney disease, atherosclerotic renal artery stenosis and abdominal aortic 
aneurysms. In this narrative review, the associations of these diseases with 
MetS and its components will be discussed. These associations may further 
increase CVD risk in MetS patients, highlighting the importance of treating such 
high-risk individuals early and "to target". In this context, multifactorial 
treatment including a statin has been proven beneficial, and thus should be 
considered, in MetS patients.