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Subsp. <jats:italic>atlantica<\/jats:italic>. Its strong antioxidant, antiinflammatory, endothelium\u2010dependent vasodilator activity, and also its anti\u2010thrombotic effects make it appropriate for targeting the multifaceted pathophysiology of metabolic syndrome. Clinical studies have shown that it can reduce blood glucose levels in people with diabetes, blood pressure in mild to moderate hypertensive patients, and waist circumference, and improve lipid profile, renal and endothelial functions in metabolic syndrome. This review highlights the pathophysiology of metabolic syndrome and related clinical research findings on the safety and efficacy of Pycnogenol\u00ae. The results of clinical research studies performed with Pycnogenol\u00ae are discussed using an evidence\u2010based, target\u2010oriented approach following the pathophysiology of individual components as well as in metabolic syndrome overall. 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