Cardiovascular disease is the leading cause of death in the industrialized world. Being multiple risk factors for atherosclerosis it emerged the concept of global cardiovascular risk assessment. Furthermore, risk factors clustered together. The metabolic syndrome, as the confluence of risk factors of metabolic origin, is associated with cardiovascular disease and type 2 diabetes. A clinical diagnosis of metabolic syndrome allows to identify individuals at high risk of developing cardiovascular disease and type 2 diabetes and it affects therapeutic strategies for primary prevention. Although changes in lifestyle are fundamental to treat all the risk factors, pharmacologic interventions targeting the single component of the syndrome also play an important role. Increasingly, an alternative strategy is available and attractive: the introduction of therapies targeting multiple risk factors simultaneously through a combination of 2 or more drugs into a single capsule.