<qa>  What is the metabolic syndrome defined as?A striking feature of the Harris County Hospital District heart failure population is that the prevalence of obesity 50.8 and the metabolic syndrome 48.9 exceeds that of the general U.S. population. The metabolic syndrome is defined as the presence of 3 out of 5 components: abdominal obesity, elevated blood pressure, dyslipidemias triglycerides and high density lipoprotein and insulin resistance and hyperglycemia. Current treatment recommendations for the metabolic syndrome include lifestyle modification diet, exercise, and weight control and targeted pharmaceutical therapy for the individual components. Although specialized care for the metabolic syndrome has not been reported, separately, both specialty heart failure care and endocrinology care have been shown to reduce hospital admissions and health care costs, increase target medication titration and disease control, improve quality of life, and survival in patients with heart failure and diabetes respectively. As both heart failure and the metabolic syndrome are commonly found in the same patients, collaborative out-patient management of both conditions in the same clinic is novel and may have a significant impact on outcomes. 