The important role of the metabolic syndrome in the development of coronary heart disease. The metabolic syndrome consists of multiple clinical syndromes and metabolic abnormalities, which accelerates the atherosclerotic process. The NCEP ATP III guidelines allows for an easier identifications of these patients at risk. While insulin resistance is central to the development of coronary heart disease, it can be seen that each of the components now contained within the metabolic syndrome can individually contribute to CHD risk. Each of these factors is combined as in the metabolic syndrome they become synergistic.