To date, current guidelines do not specifically address themanagement of mild to moderate hypertension and RHTN in the patient with MetS.However, considering the increased risk of developing diabetes in these patients, itseems reasonable that the first consideration in antihypertensive treatment is to befocused on the inhibition of the renin-angiotensin system with either angiotensinconverting enzyme or angiotensin II receptor inhibitors.34 There has been increasing interest in combinationstrategies of antihypertensive agents in RHTN patients with MetS to reduce the pillburden. The gene discussed is REN; the disease is diabetes mellitus.