Abstract : SUMMARARY : A patient with abdominal obesity, type 2 diabetes, arterial hypertension and dyslipidaemia is exposed to a high risk of coronary artery disease, congestive heart failure and/or renal insufficiency. The management of such a patient requires different medications, which should be prescribed by taking into account both (relative and absolute) indications and contra-indications to improve overall prognosis. The present clinical case report illustrates the therapeutic reasoning leading to an appropriate pharmacological polytherapy, combined with life-style changes.