The Gulliver syndrome: a conceptual framework to address therapeutic inertia in patients with borderline cardiovascular risk profiles

We propose a novel clinical construct, the “Gulliver syndrome”, to describe the scenario in which multiple, mildly elevated cardiovascular risk factors (CVRFs) coexist within an individual and together result in a significantly heightened overall risk of cardiovascular disease (CVD). This accumulati...

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Bibliographic Details
Main Authors: José Francisco López-Gil, José Abellán-Huerta, José Abellán-Alemán
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1652447/full
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Summary:We propose a novel clinical construct, the “Gulliver syndrome”, to describe the scenario in which multiple, mildly elevated cardiovascular risk factors (CVRFs) coexist within an individual and together result in a significantly heightened overall risk of cardiovascular disease (CVD). This accumulation of small deviations, often dismissed in clinical practice, can exert a synergistic impact on vascular health. Our aim is to formalize this underrecognized phenotype, which falls outside traditional diagnostic entities such as the metabolic syndrome, and to provide a framework that enables early recognition and management. We outline proposed diagnostic criteria, contrast this syndrome with related constructs, support its clinical relevance with emerging literature, and present a representative case. Ultimately, we advocate for this framework as a tool to overcome therapeutic inertia and encourage proactive, multifactorial interventions in primary and preventive care.
ISSN:2297-055X